| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $809.67 | $1,768.00 | $2,827.00 | |
Aetna
| Facility | 52 | $404.84 | $404.84 | $404.84 |
Aetna
| Facility | 53 | $161.93 | $161.93 | $161.93 |
BCBS
| Facility | $11,449.67 | $13,894.72 | $18,692.84 | |
Cigna
| Facility | $5,250.00 | $11,123.00 | $13,458.00 | |
United
| Facility | $1,404.00 | $6,113.00 | $15,920.00 |