| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $420.24 | $4,933.00 | $4,933.00 | |
BCBS
| Facility | $161.63 | $240.63 | $524.33 | |
Health Alliance Plan
| Facility | $353.07 | $4,933.00 | $4,933.00 | |
United
| Facility | $5,000.00 | $10,192.00 | $14,705.00 |