| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,553.23 | $4,933.00 | $6,853.00 | |
BCBS
| Facility | $4,562.67 | $5,317.95 | $7,204.97 | |
Health Alliance Plan
| Facility | $1,646.63 | $4,933.00 | $6,853.00 | |
United
| Facility | $3,500.00 | $8,030.00 | $12,726.00 |