| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $544.64 | $1,386.00 | $11,093.00 | |
Aetna
| Facility | 53 | $108.93 | $115.08 | $149.66 |
Anthem BCBS
| Facility | $1,646.00 | $33,179.40 | $50,875.00 | |
CareSource
| Facility | $451.66 | $575.64 | $664.20 | |
Cigna
| Facility | $10,234.40 | $10,234.40 | $10,234.40 | |
United
| Facility | $10,855.00 | $16,525.00 | $25,270.00 |