| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $911.99 | $4,933.00 | $6,922.04 | |
BCBS
| Facility | $3,650.31 | $4,929.09 | $11,575.32 | |
Health Alliance Plan
| Facility | $747.69 | $3,143.51 | $6,922.04 | |
United
| Facility | $4,635.00 | $10,032.00 | $12,767.00 |