| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $248.39 | $4,933.00 | $4,933.00 | |
BCBS
| Facility | $956.80 | $1,115.19 | $1,510.90 | |
Health Alliance Plan
| Facility | $223.60 | $4,933.00 | $4,933.00 | |
United
| Facility | $1,906.00 | $4,645.00 | $6,740.00 |