| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $483.89 | $4,112.00 | $4,933.00 | |
BCBS
| Facility | $3,569.82 | $4,160.75 | $5,637.16 | |
Health Alliance Plan
| Facility | $1,327.15 | $4,112.00 | $4,933.00 | |
United
| Facility | $5,000.00 | $10,192.00 | $14,705.00 |