| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $199.53 | $4,897.79 | $4,897.79 | |
BCBS
| Facility | $138.04 | $138.04 | $218.78 | |
Health Alliance Plan
| Facility | $199.53 | $512.86 | $4,897.79 | |
United
| Facility | $1,698.24 | $3,890.45 | $6,025.60 |