| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $272.13 | $7,602.00 | $52,899.52 | |
BCBS
| Facility | $108.00 | $143.00 | $388.00 | |
Lucent Health
| Facility | $55.00 | $576.76 | $594.13 | |
Lucent Health
| Facility | AS | $30.81 | $59.41 | $59.41 |
United
| Facility | $1,233.00 | $2,665.00 | $4,918.00 |