| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $269.64 | $4,933.00 | $4,933.00 | |
BCBS
| Facility | $996.13 | $1,161.03 | $1,573.00 | |
Health Alliance Plan
| Facility | $230.16 | $4,933.00 | $4,933.00 | |
United
| Facility | $1,906.00 | $4,645.00 | $6,740.00 |