| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $731.43 | $4,933.00 | $8,361.00 | |
BCBS
| Facility | $16,631.16 | $19,413.59 | $26,446.65 | |
Health Alliance Plan
| Facility | $612.91 | $4,933.00 | $8,361.00 | |
United
| Facility | $5,000.00 | $10,359.00 | $12,767.00 |