| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,175.59 | $4,933.00 | $4,933.00 | |
BCBS
| Facility | $14,995.74 | $17,478.06 | $23,680.00 | |
Health Alliance Plan
| Facility | $3,493.78 | $4,933.00 | $4,933.00 | |
United
| Facility | $1,906.00 | $4,645.00 | $6,740.00 |