| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,797.00 | $4,797.00 | $4,933.00 | |
BCBS
| Facility | $31,194.56 | $42,321.44 | $97,522.11 | |
Health Alliance Plan
| Facility | $4,797.00 | $4,797.00 | $4,933.00 | |
Health Alliance Plan
| Professional | $4,797.00 | $4,797.00 | $4,933.00 | |
United
| Facility | $10,555.00 | $18,687.00 | $25,752.00 |