| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $77.62 | $2,041.74 | $4,897.79 | |
BCBS
| Facility | $17.38 | $17.38 | $17.38 | |
Health Alliance Plan
| Facility | $83.18 | $1,995.26 | $4,897.79 | |
United
| Facility | $954.99 | $2,238.72 | $4,466.84 |