| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $744.88 | $4,933.00 | $92,168.39 | |
BCBS
| Facility | $62,925.31 | $86,013.36 | $198,353.66 | |
Health Alliance Plan
| Facility | $583.21 | $4,112.00 | $92,168.39 | |
United
| Facility | $10,555.00 | $25,069.00 | $55,239.00 |