| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $400.00 | $1,299.00 | $3,728.00 | |
Aetna
| Facility | 52 | $109.63 | $168.00 | $377.10 |
BCBS
| Facility | $1,595.68 | $3,102.55 | $6,544.02 | |
Christus
| Facility | $6,093.89 | $6,093.89 | $6,093.89 | |
United
| Facility | $882.00 | $3,238.00 | $8,257.00 |