| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,100.00 | $2,250.00 | $10,095.45 | |
Aetna
| Facility | 52 | $668.81 | $668.81 | $668.81 |
Aetna
| Facility | 53 | $267.52 | $267.52 | $267.52 |
BCBS
| Facility | $13,455.92 | $16,329.40 | $21,968.27 | |
United
| Facility | $1,074.00 | $3,816.00 | $7,227.00 |