| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,501.28 | $4,933.00 | $6,853.00 | |
BCBS
| Facility | $15,808.33 | $18,554.33 | $25,138.17 | |
Health Alliance Plan
| Facility | $1,200.06 | $4,933.00 | $6,853.00 | |
United
| Facility | $5,356.00 | $11,464.00 | $15,011.00 |