| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $338.84 | $4,897.79 | $4,897.79 | |
BCBS
| Facility | $75.86 | $380.19 | $380.19 | |
Health Alliance Plan
| Facility | $338.84 | $851.14 | $4,897.79 | |
United
| Facility | $9,332.54 | $12,302.69 | $16,982.44 |