| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $494.79 | $2,877.00 | $4,933.00 | |
BCBS
| Facility | $30,187.76 | $35,431.55 | $48,004.12 | |
Health Alliance Plan
| Facility | $402.61 | $2,877.00 | $4,933.00 | |
United
| Facility | $6,798.00 | $17,263.00 | $23,744.00 |