| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $562.34 | $4,073.80 | $4,897.79 | |
BCBS
| Facility | $107.15 | $630.96 | $630.96 | |
Health Alliance Plan
| Facility | $467.74 | $1,348.96 | $4,897.79 | |
United
| Facility | $630.96 | $4,786.30 | $10,232.93 |