| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $123.48 | $2,056.00 | $4,933.00 | |
BCBS
| Facility | $1,805.30 | $2,107.33 | $2,870.76 | |
Health Alliance Plan
| Facility | $123.48 | $2,056.00 | $4,933.00 | |
United
| Facility | $1,527.00 | $4,857.00 | $6,327.00 |