| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $21.38 | $4,933.00 | $4,933.00 | |
BCBS
| Facility | $76.98 | $90.19 | $126.89 | |
CareSource
| Facility | $15.02 | $20.28 | $22.31 | |
Health Alliance Plan
| Facility | $17.80 | $4,933.00 | $4,933.00 | |
United
| Facility | $464.00 | $1,418.00 | $2,449.00 |