| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $108.00 | $4,933.00 | $4,933.00 | |
BCBS
| Facility | $309.25 | $457.23 | $612.90 | |
Health Alliance Plan
| Facility | $88.31 | $4,933.00 | $4,933.00 | |
United
| Facility | $125.00 | $1,209.00 | $1,844.00 |