| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,622.39 | $4,933.00 | $4,933.00 | |
BCBS
| Facility | $6,530.17 | $9,654.87 | $13,329.50 | |
Health Alliance Plan
| Facility | $1,283.15 | $4,933.00 | $4,933.00 | |
United
| Facility | $5,356.00 | $11,464.00 | $13,668.00 |