| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,015.59 | $3,015.60 | $4,933.00 | |
BCBS
| Facility | $10,712.87 | $12,720.22 | $17,470.93 | |
Health Alliance Plan
| Facility | $2,422.71 | $3,015.60 | $4,933.00 | |
United
| Facility | $850.00 | $4,645.00 | $6,036.00 |