| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $214.79 | $4,933.00 | $4,933.00 | |
BCBS
| Facility | $9,775.20 | $13,361.84 | $30,813.46 | |
Health Alliance Plan
| Facility | $194.29 | $4,933.00 | $4,933.00 | |
United
| Facility | $5,000.00 | $10,192.00 | $14,705.00 |