| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,389.14 | $5,102.00 | $30,399.55 | |
Aetna
| Facility | 50 | $1,794.00 | $1,794.00 | $1,794.00 |
BCBS
| Facility | $2,430.00 | $7,194.00 | $13,498.00 | |
Lucent Health
| Facility | $55.00 | $27,110.45 | $27,110.45 | |
Lucent Health
| Facility | AS | $287.36 | $2,569.69 | $2,569.69 |
United
| Facility | $2,271.00 | $5,605.00 | $10,104.00 |