| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $288.40 | $2,041.74 | $4,897.79 | |
BCBS
| Facility | $263.03 | $263.03 | $263.03 | |
Health Alliance Plan
| Facility | $776.25 | $2,041.74 | $4,897.79 | |
United
| Facility | $467.74 | $1,258.93 | $2,041.74 |