| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $446.68 | $4,073.80 | $6,456.54 | |
BCBS
| Facility | $758.58 | $758.58 | $758.58 | |
Health Alliance Plan
| Facility | $416.87 | $4,073.80 | $6,456.54 | |
United
| Facility | $1,258.93 | $3,981.07 | $7,244.36 |