| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,500.00 | $4,500.00 | $5,519.00 | |
Aetna
| Professional | $4,500.00 | $4,500.00 | $4,500.00 | |
Regence BlueShield
| Facility | $22,903.92 | $47,496.36 | $58,364.17 | |
United
| Facility | $10,606.00 | $11,004.00 | $13,715.00 |