| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,470.00 | $7,629.00 | $14,886.00 | |
Aetna
| Facility | 52 | $655.87 | $655.87 | $735.00 |
Aetna
| Facility | 53 | $262.35 | $262.35 | $294.00 |
Anthem BCBS
| Facility | $12,098.00 | $12,905.00 | $17,206.00 | |
United
| Facility | $5,944.00 | $10,653.00 | $16,639.00 |