| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $193.52 | $2,145.78 | $4,286.64 | |
BCBS
| Facility | $56,799.99 | $68,899.99 | $81,099.99 | |
Providence
| Facility | $125.85 | $125.85 | $161.96 | |
United
| Facility | $775.00 | $1,327.00 | $1,327.00 |