| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,500.00 | $4,805.00 | $6,899.00 | |
Aetna
| Professional | $4,500.00 | $4,500.00 | $4,805.00 | |
Regence BlueShield
| Facility | $19,901.47 | $27,841.54 | $35,402.06 | |
United
| Facility | $12,000.00 | $24,599.00 | $65,746.00 |