| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,571.64 | $9,403.00 | $33,465.00 | |
Aetna
| Facility | 50 | $51,463.37 | $51,463.37 | $51,463.37 |
Regence BlueShield
| Facility | $20,314.50 | $25,330.44 | $36,365.48 | |
Regence BlueShield
| Facility | 50 | $30,471.77 | $37,995.66 | $54,548.22 |
United
| Facility | $3,340.00 | $10,927.00 | $47,431.00 |