| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,943.67 | $4,112.00 | $4,933.00 | |
BCBS
| Facility | $5,584.36 | $8,256.48 | $11,067.58 | |
Health Alliance Plan
| Facility | $1,587.17 | $4,112.00 | $4,933.00 | |
United
| Facility | $850.00 | $4,645.00 | $6,036.00 |