| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,500.00 | $9,804.54 | $9,804.54 | |
Aetna
| Professional | $9,804.54 | $9,804.54 | $9,804.54 | |
Regence BlueShield
| Facility | $10,480.23 | $22,875.82 | $28,539.36 | |
United
| Facility | $5,550.00 | $12,152.00 | $12,233.00 |