| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $723.55 | $4,387.00 | $8,344.00 | |
Aetna
| Facility | 54 | $542.66 | $542.66 | $542.66 |
Regence BlueShield
| Facility | $3,435.37 | $4,418.50 | $6,439.02 | |
United
| Facility | $1,981.00 | $3,613.00 | $7,048.00 |