| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,077.15 | $4,933.00 | $4,933.00 | |
BCBS
| Facility | $3,084.97 | $4,561.13 | $6,114.07 | |
Health Alliance Plan
| Facility | $870.83 | $4,933.00 | $4,933.00 | |
United
| Facility | $1,450.00 | $5,819.00 | $7,355.00 |