| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $164.25 | $2,056.00 | $4,933.00 | |
BCBS
| Facility | $495.61 | $671.55 | $1,039.77 | |
BCBS
| Facility | 50 | $350.42 | $497.59 | $630.94 |
Health Alliance Plan
| Facility | $138.33 | $2,056.00 | $4,933.00 | |
United
| Facility | $464.00 | $1,418.00 | $2,449.00 |