| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $106.17 | $2,513.94 | $5,051.74 | |
Aetna
| Facility | 52 | $47.00 | $115.03 | $706.46 |
Anthem BCBS
| Facility | $122.93 | $122.93 | $237.25 | |
CareSource
| Facility | $88.05 | $112.22 | $1,299.31 | |
United
| Facility | $933.00 | $2,252.00 | $4,426.00 |