| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $226.30 | $4,846.00 | $9,701.08 | |
Aetna
| Facility | 52 | $113.15 | $113.15 | $176.28 |
Anthem BCBS
| Facility | $2,234.00 | $5,117.00 | $8,240.00 | |
CareSource
| Facility | $208.61 | $271.19 | $312.92 | |
Cigna
| Facility | $260.75 | $761.00 | $1,158.10 | |
Cigna
| Facility | 52 | $204.01 | $204.01 | $204.01 |
United
| Facility | $900.00 | $3,817.00 | $5,402.00 |