| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $312.94 | $1,305.00 | $3,804.00 | |
Aetna
| Facility | 52 | $156.47 | $156.47 | $254.12 |
Aetna
| Facility | 53 | $62.59 | $62.59 | $101.65 |
BCBS
| Facility | $1,101.34 | $1,101.34 | $1,255.54 | |
Cigna
| Facility | $515.00 | $561.00 | $681.35 | |
United
| Facility | $505.00 | $1,106.00 | $2,539.00 |