| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,423.87 | $4,933.00 | $5,757.00 | |
BCBS
| Facility | $5,193.18 | $6,095.28 | $8,258.14 | |
Health Alliance Plan
| Facility | $1,176.76 | $4,933.00 | $5,757.00 | |
United
| Facility | $4,635.00 | $10,192.00 | $14,705.00 |