| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $828.00 | $4,933.00 | $5,757.00 | |
BCBS
| Facility | $2,632.67 | $3,068.46 | $4,157.28 | |
Health Alliance Plan
| Facility | $654.50 | $4,933.00 | $5,757.00 | |
United
| Facility | $1,450.00 | $5,708.00 | $8,884.00 |