| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,000.00 | $7,838.38 | $14,860.56 | |
Aetna
| Facility | 52 | $431.96 | $431.96 | $431.96 |
Aetna
| Facility | 53 | $172.78 | $172.78 | $172.78 |
BCBS
| Facility | $56,799.99 | $68,899.99 | $81,099.99 | |
United
| Facility | $7,315.00 | $11,259.00 | $12,494.00 |