| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,131.25 | $4,933.00 | $5,757.00 | |
BCBS
| Facility | $3,984.37 | $4,676.47 | $6,335.88 | |
Health Alliance Plan
| Facility | $876.01 | $4,933.00 | $5,757.00 | |
United
| Facility | $4,635.00 | $10,192.00 | $12,767.00 |