| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $356.23 | $1,083.00 | $3,109.00 | |
Aetna
| Facility | 54 | $262.52 | $372.05 | $482.31 |
BCBS
| Facility | $464.60 | $464.60 | $557.52 | |
Cigna
| Facility | $768.90 | $768.90 | $768.90 | |
United
| Facility | $130.00 | $330.00 | $858.00 |