| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $28.18 | $2,041.74 | $4,897.79 | |
BCBS
| Facility | $19.95 | $19.95 | $31.62 | |
Health Alliance Plan
| Facility | $21.88 | $2,041.74 | $4,897.79 | |
United
| Facility | $125.89 | $707.95 | $1,737.80 |