| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $85.87 | $4,933.00 | $4,933.00 | |
BCBS
| Facility | $411.60 | $483.09 | $654.52 | |
Health Alliance Plan
| Facility | $85.87 | $91.73 | $4,933.00 | |
United
| Facility | $300.00 | $1,418.00 | $2,029.00 |