| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $185.48 | $3,038.00 | $4,707.00 | |
Aetna
| Facility | 52 | $92.74 | $92.74 | $171.05 |
Regence BlueShield
| Facility | $2,475.05 | $3,218.11 | $4,689.71 | |
United
| Facility | $1,689.00 | $2,312.00 | $4,640.00 |