| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $123.03 | $2,089.30 | $4,897.79 | |
BCBS
| Facility | $141.25 | $141.25 | $208.93 | |
Health Alliance Plan
| Facility | $123.03 | $2,041.74 | $4,897.79 | |
United
| Facility | $954.99 | $2,238.72 | $4,466.84 |