| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $114.82 | $1,288.25 | $4,897.79 | |
BCBS
| Facility | $25.70 | $25.70 | $128.82 | |
Health Alliance Plan
| Facility | $117.49 | $1,548.82 | $4,897.79 | |
United
| Facility | $676.08 | $2,398.83 | $5,623.41 |