| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $288.40 | $2,691.53 | $4,365.16 | |
Aetna
| Professional | $288.40 | $288.40 | $288.40 | |
BCBS
| Facility | $870.96 | $1,621.81 | $2,570.40 | |
United
| Facility | $338.84 | $1,096.48 | $2,454.71 |