| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $360.43 | $2,507.00 | $7,050.44 | |
Aetna
| Facility | 52 | $118.11 | $145.57 | $642.78 |
Anthem BCBS
| Facility | $770.00 | $1,581.00 | $3,523.00 | |
Medica
| Facility | $236.22 | $1,285.56 | $3,280.98 | |
Medica
| Facility | 52 | $869.54 | $869.54 | $869.54 |
United
| Facility | $1,644.00 | $2,959.00 | $5,829.00 |