| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,403.02 | $4,933.00 | $24,077.28 | |
BCBS
| Facility | $7,944.08 | $9,273.14 | $12,632.56 | |
Health Alliance Plan
| Facility | $1,138.79 | $4,933.00 | $24,077.28 | |
United
| Facility | $4,700.00 | $8,847.00 | $10,652.00 |