| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,344.02 | $5,982.00 | $11,332.00 | |
Aetna
| Facility | 50 | $3,777.85 | $4,808.37 | $8,003.00 |
Aetna
| Facility | 52 | $672.01 | $672.01 | $1,216.42 |
United
| Facility | $4,415.00 | $7,250.00 | $10,536.00 |