| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $528.77 | $4,112.00 | $4,933.00 | |
BCBS
| Facility | $54,023.60 | $62,966.40 | $85,309.47 | |
Health Alliance Plan
| Facility | $421.58 | $4,112.00 | $4,933.00 | |
United
| Facility | $10,555.00 | $25,069.00 | $55,239.00 |