| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $960.00 | $1,728.00 | $2,707.33 | |
Aetna
| Facility | 52 | $1,353.67 | $1,353.67 | $1,353.67 |
BCBS
| Facility | $2,660.17 | $3,228.25 | $4,343.02 | |
United
| Facility | $650.00 | $1,754.00 | $4,083.00 |