| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,297.65 | $4,933.00 | $4,933.00 | |
BCBS
| Facility | $3,736.44 | $5,524.33 | $7,405.21 | |
Health Alliance Plan
| Facility | $1,061.18 | $4,933.00 | $4,933.00 | |
United
| Facility | $850.00 | $4,645.00 | $6,036.00 |