| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,707.00 | $9,175.00 | $46,444.00 | |
Aetna
| Facility | 52 | $386.88 | $386.88 | $437.27 |
Aetna
| Facility | 53 | $154.75 | $154.75 | $174.91 |
Anthem BCBS
| Facility | $5,646.00 | $21,733.12 | $80,690.00 | |
United
| Facility | $7,419.00 | $11,674.00 | $35,418.00 |