| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $295.12 | $1,905.46 | $4,897.79 | |
BCBS
| Facility | $66.07 | $66.07 | $331.13 | |
Health Alliance Plan
| Facility | $295.12 | $1,380.38 | $4,897.79 | |
United
| Facility | $588.84 | $2,630.27 | $5,623.41 |