| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $884.79 | $4,112.00 | $4,933.00 | |
BCBS
| Facility | $3,196.92 | $3,752.24 | $5,083.68 | |
Health Alliance Plan
| Facility | $701.78 | $4,112.00 | $4,933.00 | |
United
| Facility | $2,500.00 | $7,780.00 | $9,202.00 |