| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $683.68 | $4,933.00 | $4,933.00 | |
BCBS
| Facility | $828.53 | $965.68 | $1,308.33 | |
Health Alliance Plan
| Facility | $540.99 | $4,933.00 | $4,933.00 | |
United
| Facility | $773.00 | $3,005.00 | $4,594.00 |