| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,897.79 | $5,754.40 | $22,908.68 | |
BCBS
| Facility | $3,630.78 | $3,630.78 | $3,630.78 | |
Health Alliance Plan
| Facility | $4,265.80 | $4,897.79 | $8,128.31 | |
United
| Facility | $5,623.41 | $10,964.78 | $28,183.83 |