| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $800.00 | $1,399.00 | $2,250.00 | |
Aetna
| Facility | 52 | $652.98 | $652.98 | $652.98 |
BCBS
| Facility | $18,289.87 | $22,195.61 | $29,860.20 | |
United
| Facility | $4,200.00 | $8,790.00 | $15,824.00 |