| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,654.91 | $4,933.00 | $4,933.00 | |
BCBS
| Facility | $13,119.86 | $15,291.65 | $20,717.75 | |
Health Alliance Plan
| Facility | $3,050.33 | $4,933.00 | $4,933.00 | |
United
| Facility | $1,906.00 | $4,645.00 | $6,740.00 |