| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $242.17 | $4,396.00 | $10,300.00 | |
Aetna
| Facility | 52 | $115.32 | $115.32 | $121.09 |
Anthem BCBS
| Facility | $5,088.00 | $6,151.00 | $10,920.00 | |
Hometown Health
| Professional | $4.00 | $228.65 | $332.03 | |
United
| Facility | $1,061.00 | $2,606.00 | $6,471.00 |