| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $245.47 | $4,897.79 | $4,897.79 | |
BCBS
| Facility | $269.15 | $269.15 | $269.15 | |
Health Alliance Plan
| Facility | $309.03 | $851.14 | $4,897.79 | |
United
| Facility | $1,698.24 | $3,890.45 | $6,025.60 |