| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $385.05 | $3,038.00 | $7,568.00 | |
Aetna
| Facility | 54 | $288.79 | $288.79 | $408.12 |
Regence BlueShield
| Facility | $765.38 | $1,043.22 | $1,520.27 | |
United
| Facility | $1,078.00 | $1,556.00 | $4,495.00 |