| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $794.33 | $4,897.79 | $4,897.79 | |
BCBS
| Facility | $870.96 | $870.96 | $870.96 | |
Health Alliance Plan
| Facility | $794.33 | $1,995.26 | $4,897.79 | |
United
| Facility | $4,265.80 | $9,120.11 | $14,791.08 |