| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $263.89 | $4,933.00 | $4,933.00 | |
BCBS
| Facility | $959.17 | $1,118.83 | $1,574.12 | |
Health Alliance Plan
| Facility | $226.34 | $4,933.00 | $4,933.00 | |
United
| Facility | $464.00 | $1,418.00 | $2,449.00 |