| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $582.89 | $1,688.00 | $3,109.00 | |
Aetna
| Facility | 50 | $751.50 | $1,849.50 | $4,289.55 |
BCBS
| Facility | $6,292.46 | $6,292.46 | $7,550.95 | |
United
| Facility | $1,240.00 | $2,314.00 | $5,652.00 |