| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $535.20 | $2,678.00 | $7,602.00 | |
BCBS
| Facility | $108.00 | $147.00 | $2,759.00 | |
Lucent Health
| Facility | $55.00 | $2,922.50 | $2,922.50 | |
Lucent Health
| Facility | AS | $64.52 | $125.10 | $125.10 |
United
| Facility | $1,200.00 | $2,665.00 | $4,918.00 |