| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $214.07 | $4,933.00 | $5,757.00 | |
BCBS
| Facility | $2,788.05 | $3,254.50 | $4,433.52 | |
Health Alliance Plan
| Facility | $122.28 | $4,933.00 | $5,757.00 | |
United
| Facility | $1,527.00 | $4,857.00 | $6,327.00 |