| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $856.59 | $4,112.00 | $4,933.00 | |
BCBS
| Facility | $5,398.78 | $6,336.58 | $8,585.06 | |
Health Alliance Plan
| Facility | $641.32 | $4,112.00 | $4,933.00 | |
United
| Facility | $4,635.00 | $10,192.00 | $12,767.00 |