| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $902.00 | $4,136.00 | $10,504.23 | |
Aetna
| Facility | 50 | $1,377.63 | $7,168.50 | $12,243.43 |
Anthem BCBS
| Facility | $23,168.00 | $52,895.00 | $73,771.00 | |
United
| Facility | $1,347.00 | $3,983.00 | $6,832.00 |