| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $524.81 | $1,548.82 | $8,709.64 | |
BCBS
| Facility | $3,548.13 | $12,589.25 | $19,952.62 | |
Providence
| Facility | $346.74 | $501.19 | $831.76 | |
United
| Facility | $645.65 | $6,606.93 | $21,877.62 |