| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $519.99 | $7,031.50 | $26,563.03 | |
Aetna
| Facility | 52 | $245.21 | $260.00 | $336.91 |
Aetna
| Facility | 53 | $98.08 | $104.00 | $134.76 |
Anthem BCBS
| Facility | $313.80 | $42,766.00 | $63,916.00 | |
CareSource
| Facility | $406.68 | $518.32 | $598.07 | |
United
| Facility | $10,855.00 | $16,525.00 | $25,270.00 |