| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $585.44 | $1,871.90 | $57,371.33 | |
Aetna
| Facility | 53 | $117.09 | $117.09 | $207.25 |
Anthem BCBS
| Facility | $11,040.00 | $36,790.80 | $47,628.00 | |
CareSource
| Facility | $568.83 | $739.48 | $853.25 | |
United
| Facility | $5,897.00 | $13,813.00 | $28,128.00 |