| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $494.59 | $2,922.00 | $9,995.19 | |
Aetna
| Facility | 54 | $370.94 | $370.94 | $370.94 |
Regence BlueShield
| Facility | $340.97 | $447.13 | $651.60 | |
United
| Facility | $1,078.00 | $1,556.00 | $4,495.00 |