| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,045.40 | $4,933.00 | $13,782.83 | |
BCBS
| Facility | $18,572.34 | $25,078.64 | $58,893.87 | |
BCBS
| Facility | 50 | $10,006.08 | $14,663.93 | $19,885.06 |
Health Alliance Plan
| Facility | $539.79 | $4,933.00 | $13,782.83 | |
United
| Facility | $5,356.00 | $11,464.00 | $15,011.00 |