| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $641.32 | $2,688.46 | $9,504.00 | |
Aetna
| Facility | 50 | $605.53 | $605.53 | $605.53 |
Anthem BCBS
| Facility | $1,145.00 | $2,786.00 | $8,800.00 | |
CareSource
| Facility | $177.65 | $213.18 | $333.09 | |
Cigna
| Facility | $21,571.00 | $21,571.00 | $21,571.00 | |
United
| Facility | $1,020.00 | $1,952.00 | $4,132.00 |