| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,010.96 | $4,933.00 | $4,933.00 | |
BCBS
| Facility | $3,634.57 | $4,242.64 | $5,779.64 | |
Health Alliance Plan
| Facility | $838.91 | $4,933.00 | $4,933.00 | |
United
| Facility | $1,906.00 | $4,645.00 | $6,327.00 |