| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,163.07 | $4,933.00 | $4,933.00 | |
BCBS
| Facility | $4,221.89 | $4,928.22 | $6,713.61 | |
Health Alliance Plan
| Facility | $964.69 | $4,933.00 | $4,933.00 | |
United
| Facility | $1,906.00 | $4,645.00 | $6,327.00 |