| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $50.80 | $1,295.00 | $3,804.00 | |
Aetna
| Facility | 52 | $25.21 | $25.40 | $36.54 |
Aetna
| Facility | 53 | $10.08 | $10.16 | $14.61 |
BCBS
| Facility | $384.00 | $384.00 | $437.76 | |
Cigna
| Facility | $128.09 | $198.18 | $515.00 | |
United
| Facility | $95.00 | $337.00 | $718.27 |