| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,593.50 | $4,933.00 | $4,933.00 | |
BCBS
| Facility | $9,384.17 | $11,014.26 | $14,922.57 | |
Health Alliance Plan
| Facility | $2,162.75 | $2,593.50 | $4,933.00 | |
United
| Facility | $5,356.00 | $11,464.00 | $14,085.00 |