| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $5,075.03 | $5,075.03 | $5,075.03 | |
Aetna
| Professional | $5,075.03 | $5,075.03 | $5,075.03 | |
BCBS
| Professional | $4,172.79 | $16,525.70 | $21,946.13 | |
United
| Professional | $2,072.36 | $3,237.00 | $4,075.00 |