| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,240.00 | $8,617.00 | $10,455.00 | |
Aetna
| Facility | 52 | $437.89 | $437.89 | $442.10 |
Aetna
| Facility | 53 | $175.16 | $175.16 | $176.84 |
Anthem BCBS
| Facility | $6,556.00 | $9,098.00 | $15,073.00 | |
Hometown Health
| Professional | $9.60 | $795.03 | $1,059.94 | |
United
| Facility | $2,042.00 | $4,794.00 | $10,407.00 |