| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $445.08 | $4,112.00 | $4,933.00 | |
BCBS
| Facility | $18,189.14 | $24,862.95 | $57,335.96 | |
Health Alliance Plan
| Facility | $374.70 | $4,112.00 | $4,933.00 | |
United
| Facility | $7,174.00 | $12,733.00 | $27,028.00 |