| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $97.01 | $988.00 | $6,363.50 | |
Aetna
| Facility | 52 | $45.71 | $52.35 | $555.00 |
Anthem BCBS
| Facility | $5,080.00 | $6,598.00 | $11,253.00 | |
CareSource
| Facility | $89.95 | $123.47 | $142.41 | |
Cigna
| Facility | $162.27 | $162.27 | $162.27 | |
Cigna
| Facility | 52 | $129.82 | $129.82 | $129.82 |
United
| Facility | $50.00 | $597.00 | $3,176.00 |