| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $638.19 | $4,933.00 | $4,933.00 | |
BCBS
| Facility | $1,589.12 | $1,854.99 | $2,527.00 | |
Health Alliance Plan
| Facility | $501.18 | $4,933.00 | $4,933.00 | |
United
| Facility | $773.00 | $3,005.00 | $4,504.00 |