| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $336.93 | $2,906.15 | $6,063.88 | |
Aetna
| Facility | 52 | $154.51 | $160.44 | $828.94 |
BCBS
| Facility | $3,365.47 | $4,764.46 | $11,246.76 | |
Health Alliance Plan
| Facility | $404.32 | $2,655.36 | $6,063.88 | |
Health Alliance Plan
| Facility | 52 | $154.51 | $154.51 | $798.23 |
United
| Facility | $2,524.00 | $5,819.00 | $8,339.00 |