| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $475.86 | $1,836.00 | $13,166.00 | |
Aetna
| Facility | 52 | $206.91 | $206.91 | $1,032.35 |
Aetna
| Facility | 53 | $82.76 | $82.76 | $412.94 |
BCBS
| Facility | $531.01 | $531.01 | $584.10 | |
Cigna
| Facility | $31,086.00 | $31,086.00 | $31,086.00 | |
United
| Facility | $1,390.00 | $10,905.00 | $19,044.00 |