| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $278.81 | $2,056.00 | $4,933.00 | |
BCBS
| Facility | $11,204.62 | $13,059.38 | $17,693.38 | |
Health Alliance Plan
| Facility | $1,194.60 | $2,056.00 | $4,933.00 | |
United
| Facility | $5,000.00 | $10,192.00 | $14,705.00 |