| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $450.00 | $450.00 | $450.00 | |
Aetna
| Professional | $450.00 | $450.00 | $450.00 | |
BCBS
| Facility | $683.50 | $2,506.28 | $4,083.94 | |
United
| Professional | $567.16 | $708.95 | $889.41 |