| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $645.65 | $1,548.82 | $8,709.64 | |
BCBS
| Facility | $2,691.53 | $7,943.28 | $12,589.25 | |
Providence
| Facility | $436.52 | $588.84 | $912.01 | |
United
| Facility | $645.65 | $6,606.93 | $14,125.38 |