| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,293.22 | $4,933.00 | $19,533.77 | |
BCBS
| Facility | $11,073.18 | $12,996.66 | $17,608.41 | |
Health Alliance Plan
| Facility | $1,072.93 | $4,933.00 | $19,533.77 | |
United
| Facility | $4,635.00 | $10,192.00 | $12,767.00 |