| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $586.82 | $4,933.00 | $5,757.00 | |
BCBS
| Facility | $16,465.25 | $23,898.62 | $57,452.11 | |
Health Alliance Plan
| Facility | $484.57 | $4,933.00 | $5,757.00 | |
United
| Facility | $4,561.00 | $8,995.00 | $12,767.00 |