| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $125.89 | $2,041.74 | $4,897.79 | |
BCBS
| Facility | $131.83 | $131.83 | $131.83 | |
Health Alliance Plan
| Facility | $154.88 | $2,041.74 | $4,897.79 | |
United
| Facility | $691.83 | $1,778.28 | $4,073.80 |