| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $425.27 | $4,112.00 | $4,933.00 | |
BCBS
| Facility | $13,450.34 | $18,372.34 | $42,335.76 | |
Health Alliance Plan
| Facility | $355.26 | $4,112.00 | $4,933.00 | |
United
| Facility | $7,174.00 | $12,733.00 | $27,028.00 |