| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $873.49 | $4,933.00 | $6,102.71 | |
BCBS
| Facility | $17,032.34 | $19,990.97 | $27,084.58 | |
Health Alliance Plan
| Facility | $698.80 | $4,933.00 | $6,102.71 | |
United
| Facility | $5,356.00 | $12,127.00 | $23,945.00 |