| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $870.96 | $4,897.79 | $6,918.31 | |
BCBS
| Facility | $199.53 | $199.53 | $199.53 | |
Health Alliance Plan
| Facility | $870.96 | $2,041.74 | $6,918.31 | |
United
| Facility | $2,511.89 | $5,011.87 | $12,022.64 |