| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $169.82 | $363.08 | $2,041.74 | |
BCBS
| Facility | $47.86 | $363.08 | $363.08 | |
Health Alliance Plan
| Facility | $190.55 | $363.08 | $2,041.74 | |
United
| Facility | $100.00 | $707.95 | $1,737.80 |