| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $125.89 | $2,041.74 | $4,897.79 | |
BCBS
| Facility | $208.93 | $208.93 | $208.93 | |
Health Alliance Plan
| Facility | $120.23 | $2,041.74 | $4,897.79 | |
United
| Facility | $549.54 | $1,862.09 | $4,073.80 |