| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,960.20 | $4,213.00 | $10,300.00 | |
Aetna
| Facility | 52 | $980.10 | $980.10 | $980.10 |
Anthem BCBS
| Facility | $3,671.00 | $5,123.00 | $8,352.37 | |
Hometown Health
| Professional | $16.00 | $1,898.73 | $2,641.71 | |
United
| Facility | $776.00 | $2,578.00 | $6,471.00 |