| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $652.58 | $4,933.00 | $4,933.00 | |
BCBS
| Facility | $2,419.85 | $2,820.42 | $3,821.22 | |
Health Alliance Plan
| Facility | $558.99 | $4,933.00 | $4,933.00 | |
United
| Facility | $1,906.00 | $4,645.00 | $6,327.00 |