| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $575.00 | $1,238.00 | $2,250.00 | |
Aetna
| Facility | 52 | $763.26 | $763.26 | $763.26 |
BCBS
| Facility | $5,503.96 | $6,679.32 | $8,985.82 | |
United
| Facility | $4,200.00 | $8,790.00 | $15,824.00 |