| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,353.58 | $4,933.00 | $4,933.00 | |
BCBS
| Facility | $4,984.93 | $5,818.93 | $7,926.98 | |
Health Alliance Plan
| Facility | $1,140.60 | $4,933.00 | $4,933.00 | |
United
| Facility | $5,000.00 | $10,359.00 | $12,767.00 |