| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $597.66 | $4,136.00 | $7,633.60 | |
Aetna
| Facility | 50 | $5,093.22 | $5,093.22 | $5,093.22 |
Anthem BCBS
| Facility | $5,410.00 | $6,763.00 | $11,830.00 | |
United
| Facility | $4,565.00 | $7,010.00 | $11,152.00 |