| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $323.59 | $4,897.79 | $4,897.79 | |
BCBS
| Facility | $389.05 | $389.05 | $389.05 | |
Health Alliance Plan
| Facility | $275.42 | $741.31 | $4,897.79 | |
United
| Facility | $467.74 | $3,548.13 | $6,025.60 |