| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,449.87 | $3,959.00 | $10,300.00 | |
Aetna
| Facility | 52 | $724.94 | $724.94 | $724.94 |
Anthem BCBS
| Facility | $3,671.00 | $5,123.00 | $8,352.37 | |
Hometown Health
| Professional | $14.80 | $1,403.47 | $1,980.43 | |
United
| Facility | $776.00 | $2,578.00 | $6,471.00 |