| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,513.56 | $4,677.35 | $11,481.54 | |
Aetna
| Facility | 50 | $9,332.54 | $15,848.93 | $67,608.30 |
BCBS
| Facility | $4,570.88 | $13,489.63 | $28,840.32 | |
Cigna
| Facility | $398.11 | $3,630.78 | $10,232.93 | |
Cigna
| Facility | AS | $257.04 | $257.04 | $257.04 |
United
| Facility | $851.14 | $3,162.28 | $10,232.93 |