| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $775.52 | $3,570.50 | $8,364.50 | |
Aetna
| Facility | 22 | $3,486.70 | $3,486.70 | $3,486.70 |
BCBS
| Facility | $1,755.00 | $5,379.00 | $12,173.00 | |
Cigna
| Facility | $541.36 | $1,617.27 | $6,096.00 | |
United
| Facility | $1,099.00 | $3,399.00 | $7,285.50 |