| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $173.61 | $4,933.00 | $4,933.00 | |
BCBS
| Facility | $568.91 | $663.08 | $898.37 | |
Health Alliance Plan
| Facility | $139.28 | $4,933.00 | $4,933.00 | |
United
| Facility | $1,906.00 | $4,645.00 | $6,740.00 |