| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,041.74 | $2,041.74 | $4,897.79 | |
BCBS
| Facility | $109.65 | $177.83 | $177.83 | |
Health Alliance Plan
| Facility | $125.89 | $2,041.74 | $4,897.79 | |
United
| Facility | $562.34 | $3,162.28 | $6,025.60 |