| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $960.00 | $1,443.33 | $2,250.00 | |
Aetna
| Facility | 52 | $721.67 | $721.67 | $721.67 |
BCBS
| Facility | $9,255.62 | $11,204.67 | $15,073.87 | |
United
| Facility | $650.00 | $1,754.00 | $5,201.00 |