| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $568.02 | $1,821.00 | $13,016.00 | |
Aetna
| Facility | 52 | $284.01 | $286.00 | $408.93 |
Aetna
| Facility | 53 | $113.60 | $114.40 | $163.57 |
Cigna
| Facility | $8,781.00 | $8,781.00 | $20,598.28 | |
United
| Facility | $3,079.00 | $8,643.00 | $15,659.00 |