| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,801.00 | $16,091.90 | $22,261.30 | |
BCBS
| Facility | $801.71 | $1,388.00 | $4,266.64 | |
Providence
| Facility | $5,956.08 | $5,956.08 | $5,956.08 | |
United
| Facility | $4,512.93 | $10,711.03 | $16,607.62 |