| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $870.96 | $4,897.79 | $4,897.79 | |
BCBS
| Facility | $630.96 | $1,513.56 | $1,513.56 | |
Health Alliance Plan
| Facility | $870.96 | $2,187.76 | $4,897.79 | |
United
| Facility | $5,011.87 | $9,332.54 | $13,803.84 |