| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $960.00 | $1,728.00 | $2,639.00 | |
Aetna
| Facility | 52 | $1,397.50 | $1,397.50 | $1,397.50 |
BCBS
| Facility | $12,442.51 | $15,062.66 | $20,264.09 | |
United
| Facility | $1,404.00 | $4,997.00 | $9,624.00 |