| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,328.69 | $4,933.00 | $4,933.00 | |
BCBS
| Facility | $6,784.63 | $10,031.09 | $13,848.90 | |
Health Alliance Plan
| Facility | $1,920.60 | $4,933.00 | $4,933.00 | |
United
| Facility | $850.00 | $4,645.00 | $6,036.00 |