| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $733.61 | $7,838.38 | $8,644.27 | |
BCBS
| Facility | $5,677.04 | $20,335.93 | $31,556.51 | |
Providence
| Facility | $696.48 | $910.78 | $1,768.00 | |
United
| Facility | $899.00 | $11,259.00 | $16,897.00 |