| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $963.74 | $4,933.00 | $4,933.00 | |
BCBS
| Facility | $3,444.03 | $4,089.37 | $5,616.65 | |
Health Alliance Plan
| Facility | $779.88 | $4,933.00 | $4,933.00 | |
United
| Facility | $850.00 | $4,645.00 | $6,036.00 |