| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,648.63 | $4,933.00 | $5,634.04 | |
BCBS
| Facility | $12,502.42 | $14,674.17 | $19,881.16 | |
Health Alliance Plan
| Facility | $1,349.83 | $4,933.00 | $6,906.00 | |
United
| Facility | $4,635.00 | $11,152.00 | $20,268.00 |