| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,256.00 | $3,329.00 | $7,602.00 | |
Aetna
| Facility | 22 | $4,859.00 | $4,859.00 | $4,859.00 |
BCBS
| Facility | $2,346.00 | $4,614.00 | $8,456.00 | |
Lucent Health
| Facility | $55.00 | $14,302.50 | $14,302.50 | |
United
| Facility | $2,799.00 | $5,728.00 | $10,111.00 |