| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,702.66 | $6,913.00 | $9,893.29 | |
Aetna
| Facility | 22 | $8,548.59 | $8,548.59 | $8,548.59 |
Regence BlueShield
| Facility | $8,370.62 | $10,940.20 | $15,943.01 | |
United
| Facility | $3,028.00 | $9,753.00 | $15,824.00 |