| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $244.21 | $947.84 | $4,933.00 | |
Aetna
| Facility | 52 | $117.59 | $122.11 | $290.89 |
BCBS
| Facility | $3,625.49 | $4,232.04 | $5,765.19 | |
Health Alliance Plan
| Facility | $506.25 | $1,370.00 | $4,572.13 | |
Health Alliance Plan
| Facility | 52 | $117.59 | $117.59 | $280.12 |
United
| Facility | $3,296.00 | $7,849.00 | $9,202.00 |