| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,659.59 | $2,041.74 | $4,897.79 | |
BCBS
| Facility | $190.55 | $190.55 | $309.03 | |
Health Alliance Plan
| Facility | $1,288.25 | $2,951.21 | $4,897.79 | |
United
| Facility | $4,677.35 | $10,000.00 | $12,882.50 |