| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,316.92 | $7,183.00 | $43,806.00 | |
Aetna
| Facility | 52 | $1,158.46 | $1,158.46 | $1,158.46 |
Regence BlueShield
| Facility | $20,314.50 | $25,330.44 | $36,365.48 | |
United
| Facility | $2,912.00 | $7,693.00 | $47,431.00 |