| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $121.78 | $608.57 | $2,683.00 | |
Aetna
| Facility | 52 | $31.57 | $57.20 | $160.08 |
BCBS
| Facility | $108.00 | $148.00 | $1,676.00 | |
Lucent Health
| Facility | $55.00 | $522.83 | $538.02 | |
Lucent Health
| Facility | 52 | $237.37 | $253.46 | $253.46 |
United
| Facility | $267.00 | $794.00 | $2,495.00 |