| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $212.66 | $212.66 | $212.66 | |
BCBS
| Facility | $81.14 | $157.19 | $303.70 | |
Health Alliance Plan
| Facility | $177.72 | $177.72 | $212.66 | |
United
| Facility | $700.00 | $1,247.00 | $2,029.00 |