| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,615.76 | $4,933.00 | $5,757.00 | |
BCBS
| Facility | $6,569.56 | $7,668.66 | $10,446.82 | |
Health Alliance Plan
| Facility | $1,294.35 | $4,933.00 | $5,757.00 | |
United
| Facility | $5,000.00 | $10,359.00 | $12,767.00 |