| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,778.28 | $12,882.50 | $21,877.62 | |
BCBS
| Facility | $1,995.26 | $1,995.26 | $1,995.26 | |
Health Alliance Plan
| Facility | $1,737.80 | $6,918.31 | $18,620.87 | |
United
| Facility | $4,677.35 | $7,585.78 | $13,489.63 |