| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $728.63 | $4,933.00 | $5,757.00 | |
BCBS
| Facility | $3,374.29 | $3,960.42 | $5,365.74 | |
Health Alliance Plan
| Facility | $748.15 | $4,933.00 | $5,757.00 | |
United
| Facility | $4,635.00 | $10,192.00 | $12,767.00 |