| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $504.83 | $1,251.00 | $5,500.00 | |
Aetna
| Facility | 52 | $252.42 | $252.42 | $252.42 |
BCBS
| Facility | $2,659.91 | $3,227.93 | $4,342.60 | |
United
| Facility | $750.00 | $2,769.00 | $4,402.00 |