| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,150.00 | $4,337.00 | $21,700.00 | |
Aetna
| Facility | 52 | $842.74 | $842.74 | $926.09 |
Anthem BCBS
| Facility | $6,556.00 | $9,098.00 | $30,452.43 | |
Hometown Health
| Professional | $29.60 | $1,903.28 | $11,481.22 | |
United
| Facility | $2,818.00 | $5,468.00 | $11,845.00 |