| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $641.16 | $4,933.00 | $4,933.00 | |
BCBS
| Facility | $2,805.24 | $3,834.52 | $8,842.70 | |
Health Alliance Plan
| Facility | $521.99 | $4,933.00 | $4,933.00 | |
United
| Facility | $3,296.00 | $7,780.00 | $10,556.00 |