| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,805.00 | $16,193.00 | $16,193.00 | |
Aetna
| Professional | $16,193.00 | $16,193.00 | $16,193.00 | |
Regence BlueShield
| Facility | $19,831.58 | $27,841.54 | $35,402.06 | |
United
| Facility | $12,000.00 | $62,445.00 | $76,459.00 |