| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $436.52 | $2,884.03 | $4,897.79 | |
BCBS
| Facility | $112.20 | $112.20 | $112.20 | |
Health Alliance Plan
| Facility | $213.80 | $2,884.03 | $4,897.79 | |
United
| Facility | $467.74 | $1,258.93 | $2,041.74 |