| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $448.64 | $4,112.00 | $4,933.00 | |
BCBS
| Facility | $13,317.60 | $15,522.12 | $21,030.01 | |
Health Alliance Plan
| Facility | $359.58 | $4,112.00 | $4,933.00 | |
United
| Facility | $7,174.00 | $12,733.00 | $27,028.00 |