| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $531.66 | $4,112.00 | $4,933.00 | |
BCBS
| Facility | $2,052.57 | $2,395.96 | $3,263.96 | |
Health Alliance Plan
| Facility | $423.18 | $4,112.00 | $4,933.00 | |
United
| Facility | $2,524.00 | $5,819.00 | $8,339.00 |