| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $554.16 | $4,933.00 | $49,891.89 | |
BCBS
| Facility | $52,893.18 | $72,300.32 | $166,730.29 | |
Health Alliance Plan
| Facility | $422.24 | $4,933.00 | $49,891.89 | |
United
| Facility | $10,555.00 | $25,069.00 | $55,239.00 |