| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $221.21 | $1,820.00 | $8,229.00 | |
Aetna
| Facility | 52 | $110.61 | $116.77 | $168.97 |
Anthem BCBS
| Facility | $1,421.00 | $2,435.00 | $4,516.00 | |
CareSource
| Facility | $216.55 | $297.22 | $342.87 | |
Cigna
| Facility | $260.75 | $260.75 | $260.75 | |
Cigna
| Facility | 52 | $204.01 | $204.01 | $204.01 |
United
| Facility | $523.00 | $794.00 | $5,301.00 |