| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $356.12 | $3,064.00 | $4,707.00 | |
Aetna
| Facility | 52 | $178.06 | $178.06 | $178.06 |
Aetna
| Facility | 53 | $71.22 | $71.22 | $71.22 |
Regence BlueShield
| Facility | $1,715.47 | $2,237.48 | $3,260.64 | |
United
| Facility | $1,689.00 | $2,312.00 | $4,640.00 |