| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $912.01 | $2,238.72 | $5,011.87 | |
BCBS
| Facility | $4,570.88 | $16,218.10 | $25,703.96 | |
Providence
| Facility | $616.60 | $851.14 | $1,412.54 | |
United
| Facility | $1,023.29 | $15,135.61 | $31,622.78 |