| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $407.38 | $2,884.03 | $4,897.79 | |
BCBS
| Facility | $91.20 | $91.20 | $91.20 | |
Health Alliance Plan
| Facility | $407.38 | $2,884.03 | $4,897.79 | |
United
| Facility | $4,897.79 | $8,128.31 | $12,302.69 |