| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,073.80 | $4,073.80 | $4,897.79 | |
BCBS
| Facility | $1,412.54 | $2,137.96 | $2,137.96 | |
Health Alliance Plan
| Facility | $1,202.26 | $4,073.80 | $5,754.40 | |
United
| Facility | $5,495.41 | $10,964.78 | $22,387.21 |