| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $53.33 | $1,965.00 | $7,838.38 | |
BCBS
| Facility | $56,799.99 | $68,899.99 | $81,099.99 | |
Providence
| Facility | $31.50 | $108.70 | $191.92 | |
United
| Facility | $230.00 | $1,158.00 | $1,401.00 |