| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $522.62 | $1,399.00 | $2,080.00 | |
Aetna
| Facility | 52 | $261.31 | $261.31 | $261.31 |
BCBS
| Facility | $1,273.48 | $1,545.43 | $2,079.10 | |
United
| Facility | $625.00 | $1,738.00 | $3,360.00 |