| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $549.54 | $4,570.88 | $12,882.50 | |
BCBS
| Facility | $107.15 | $389.05 | $933.25 | |
Health Alliance Plan
| Facility | $457.09 | $4,073.80 | $12,882.50 | |
United
| Facility | $891.25 | $7,079.46 | $12,882.50 |