| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,798.70 | $4,933.00 | $4,933.00 | |
BCBS
| Facility | $14,029.05 | $16,376.13 | $22,308.80 | |
Health Alliance Plan
| Facility | $3,255.00 | $4,933.00 | $4,933.00 | |
United
| Facility | $1,906.00 | $4,645.00 | $6,327.00 |