| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $254.14 | $2,877.00 | $4,933.00 | |
BCBS
| Facility | $1,331.89 | $1,554.71 | $2,117.94 | |
Health Alliance Plan
| Facility | $206.10 | $2,877.00 | $4,933.00 | |
United
| Facility | $1,527.00 | $4,857.00 | $6,327.00 |