| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $602.56 | $602.56 | $602.56 | |
BCBS
| Facility | $776.25 | $776.25 | $776.25 | |
Health Alliance Plan
| Facility | $446.68 | $549.54 | $1,174.90 | |
United
| Facility | $371.54 | $371.54 | $389.05 |