| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $932.00 | $4,933.00 | $5,757.00 | |
BCBS
| Facility | $4,121.10 | $4,803.29 | $6,507.69 | |
Health Alliance Plan
| Facility | $1,188.55 | $4,933.00 | $5,757.00 | |
United
| Facility | $3,500.00 | $8,030.00 | $12,726.00 |