| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $312.45 | $4,933.00 | $4,933.00 | |
BCBS
| Facility | $888.48 | $1,313.62 | $1,760.87 | |
Health Alliance Plan
| Facility | $255.78 | $4,933.00 | $4,933.00 | |
United
| Facility | $3,500.00 | $8,702.00 | $10,351.00 |