| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $276.02 | $4,797.00 | $8,214.10 | |
BCBS
| Facility | $120.92 | $240.92 | $438.79 | |
Health Alliance Plan
| Facility | $213.90 | $4,797.00 | $8,214.10 | |
United
| Facility | $464.00 | $1,418.00 | $2,449.00 |