| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $73.98 | $1,851.55 | $5,634.00 | |
Aetna
| Facility | 52 | $32.72 | $59.31 | $80.11 |
Anthem BCBS
| Facility | $133.78 | $133.78 | $258.20 | |
CareSource
| Facility | $61.35 | $78.20 | $149.04 | |
United
| Facility | $866.00 | $2,291.00 | $4,426.00 |