| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $960.00 | $1,728.00 | $3,092.76 | |
Aetna
| Facility | 52 | $1,546.38 | $1,546.38 | $1,546.38 |
BCBS
| Facility | $6,718.36 | $8,153.05 | $10,968.47 | |
United
| Facility | $1,485.00 | $4,121.00 | $7,227.00 |