| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $408.06 | $2,877.00 | $4,933.00 | |
BCBS
| Facility | $24,236.16 | $28,446.13 | $38,539.99 | |
Health Alliance Plan
| Facility | $319.39 | $2,877.00 | $4,933.00 | |
United
| Facility | $3,500.00 | $9,680.00 | $23,744.00 |