| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $530.22 | $1,251.00 | $4,132.30 | |
Aetna
| Facility | 50 | $617.50 | $2,910.59 | $12,221.90 |
BCBS
| Facility | $3,204.79 | $3,889.17 | $5,232.17 | |
United
| Facility | $1,485.00 | $4,121.00 | $7,227.00 |