| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,406.22 | $4,933.00 | $15,542.21 | |
BCBS
| Facility | $7,502.95 | $10,131.40 | $23,792.24 | |
Health Alliance Plan
| Facility | $1,308.91 | $4,933.00 | $15,133.18 | |
United
| Facility | $4,635.00 | $10,192.00 | $12,767.00 |