| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $106.07 | $4,933.00 | $4,933.00 | |
BCBS
| Facility | $388.27 | $452.91 | $637.21 | |
Health Alliance Plan
| Facility | $90.48 | $4,933.00 | $4,933.00 | |
United
| Facility | $1,906.00 | $4,645.00 | $6,740.00 |