| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $234.83 | $5,634.00 | $18,500.00 | |
Aetna
| Facility | 50 | $1,762.37 | $2,429.28 | $5,417.10 |
Anthem BCBS
| Facility | $246.75 | $246.75 | $476.23 | |
CareSource
| Facility | $190.92 | $242.89 | $372.30 | |
United
| Facility | $933.00 | $2,252.00 | $4,426.00 |