| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $575.00 | $960.00 | $2,250.00 | |
Aetna
| Facility | 54 | $597.10 | $597.10 | $597.10 |
BCBS
| Facility | $1,314.29 | $1,594.95 | $2,145.71 | |
United
| Facility | $625.00 | $1,768.00 | $3,360.00 |