| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $140.85 | $4,933.00 | $4,933.00 | |
BCBS
| Facility | $494.79 | $576.70 | $781.33 | |
Health Alliance Plan
| Facility | $115.30 | $4,933.00 | $4,933.00 | |
United
| Facility | $464.00 | $1,418.00 | $2,449.00 |