| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $960.00 | $1,728.00 | $3,057.08 | |
Aetna
| Facility | 53 | $611.41 | $611.41 | $611.41 |
BCBS
| Facility | $13,455.92 | $16,329.40 | $21,968.27 | |
United
| Facility | $650.00 | $1,754.00 | $5,201.00 |