| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $102.05 | $102.05 | $102.05 | |
BCBS
| Facility | $390.45 | $455.78 | $620.89 | |
Health Alliance Plan
| Facility | $77.59 | $77.59 | $102.05 | |
United
| Facility | $464.00 | $1,428.00 | $2,029.00 |