| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $454.67 | $4,933.00 | $4,933.00 | |
BCBS
| Facility | $1,638.67 | $2,239.91 | $5,165.42 | |
Health Alliance Plan
| Facility | $340.17 | $4,933.00 | $4,933.00 | |
United
| Facility | $1,906.00 | $4,645.00 | $6,740.00 |