| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $475.17 | $4,112.00 | $4,933.00 | |
BCBS
| Facility | $25,688.04 | $29,940.31 | $40,564.37 | |
Health Alliance Plan
| Facility | $376.80 | $4,112.00 | $4,933.00 | |
United
| Facility | $7,174.00 | $12,733.00 | $27,028.00 |