| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,224.26 | $4,933.00 | $4,933.00 | |
BCBS
| Facility | $4,535.91 | $5,294.78 | $7,212.94 | |
Health Alliance Plan
| Facility | $990.37 | $4,933.00 | $4,933.00 | |
United
| Facility | $1,906.00 | $4,645.00 | $6,327.00 |