| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $615.00 | $1,223.00 | $2,250.00 | |
Aetna
| Facility | 52 | $288.63 | $288.63 | $288.63 |
BCBS
| Facility | $2,724.76 | $3,306.63 | $4,448.47 | |
United
| Facility | $625.00 | $1,738.00 | $3,360.00 |