| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $817.20 | $4,933.00 | $6,853.00 | |
BCBS
| Facility | $3,804.89 | $4,434.74 | $6,008.36 | |
Health Alliance Plan
| Facility | $504.85 | $4,933.00 | $6,853.00 | |
United
| Facility | $4,635.00 | $9,143.00 | $12,767.00 |