| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $546.86 | $4,933.00 | $4,933.00 | |
BCBS
| Facility | $1,961.09 | $2,285.71 | $3,096.79 | |
CareSource
| Facility | $385.71 | $520.71 | $572.88 | |
Health Alliance Plan
| Facility | $458.20 | $4,933.00 | $4,933.00 | |
United
| Facility | $1,906.00 | $4,645.00 | $6,740.00 |