| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $515.54 | $4,933.00 | $4,933.00 | |
BCBS
| Facility | $2,793.48 | $3,255.89 | $4,411.22 | |
Health Alliance Plan
| Facility | $419.12 | $4,933.00 | $4,933.00 | |
United
| Facility | $3,296.00 | $7,780.00 | $10,556.00 |