| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,245.78 | $4,933.00 | $12,606.65 | |
BCBS
| Facility | $13,930.02 | $16,349.75 | $22,151.32 | |
Health Alliance Plan
| Facility | $960.98 | $4,933.00 | $12,606.65 | |
United
| Facility | $4,635.00 | $10,192.00 | $12,767.00 |