| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $750.00 | $1,223.00 | $2,250.00 | |
Aetna
| Facility | 54 | $910.94 | $910.94 | $910.94 |
BCBS
| Facility | $1,317.51 | $1,594.95 | $2,145.71 | |
United
| Facility | $375.00 | $1,234.00 | $2,481.00 |