| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $118.90 | $1,871.00 | $5,691.00 | |
Aetna
| Facility | 52 | $32.17 | $39.86 | $59.45 |
Anthem BCBS
| Facility | $770.00 | $1,581.00 | $3,523.00 | |
Medica
| Facility | $64.34 | $145.41 | $747.00 | |
Medica
| Facility | 52 | $237.37 | $237.37 | $237.37 |
United
| Facility | $247.00 | $719.00 | $1,795.00 |