| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $38.79 | $4,468.72 | $9,784.00 | |
Aetna
| Facility | 52 | $19.39 | $19.39 | $33.69 |
Aetna
| Facility | 53 | $7.76 | $7.76 | $13.48 |
Horizon BCBS
| Facility | $782.90 | $782.90 | $970.14 | |
United
| Facility | $1,141.00 | $2,607.00 | $5,864.00 |