| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $113.75 | $4,933.00 | $4,933.00 | |
BCBS
| Facility | $419.76 | $489.98 | $667.49 | |
Health Alliance Plan
| Facility | $97.13 | $4,933.00 | $4,933.00 | |
United
| Facility | $1,906.00 | $4,645.00 | $6,327.00 |