| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $548.86 | $548.86 | $548.86 | |
Aetna
| Professional | $548.86 | $548.86 | $548.86 | |
BCBS
| Professional | $4,560.00 | $4,560.00 | $4,560.00 | |
United
| Professional | $4,800.00 | $4,800.00 | $5,292.00 |