| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,101.50 | $3,294.00 | $6,161.00 | |
Aetna
| Facility | 54 | $826.13 | $826.13 | $826.13 |
Regence BlueShield
| Facility | $2,304.17 | $3,047.35 | $4,440.85 | |
United
| Facility | $1,689.00 | $2,312.00 | $4,640.00 |