| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $115.99 | $1,250.00 | $1,831.00 | |
Aetna
| Facility | 52 | $18.95 | $18.95 | $58.00 |
Aetna
| Facility | 53 | $7.58 | $7.58 | $23.20 |
BCBS
| Facility | $569.45 | $569.45 | $569.45 | |
Cigna
| Facility | $190.59 | $203.40 | $262.56 | |
United
| Facility | $216.00 | $537.00 | $1,893.00 |