| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,805.00 | $7,175.00 | $19,207.90 | |
Aetna
| Professional | $19,207.90 | $19,207.90 | $19,207.90 | |
Regence BlueShield
| Facility | $31,610.23 | $44,515.87 | $57,287.30 | |
United
| Facility | $12,000.00 | $62,445.00 | $76,459.00 |