| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $240.20 | $1,223.00 | $3,992.06 | |
Aetna
| Facility | 52 | $120.10 | $120.10 | $221.29 |
BCBS
| Facility | $2,185.94 | $2,652.75 | $3,568.80 | |
United
| Facility | $625.00 | $1,768.00 | $3,360.00 |