| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $100.00 | $3,991.65 | $14,307.78 | |
Aetna
| Facility | 50 | $8,694.26 | $14,549.06 | $26,010.97 |
Anthem BCBS
| Facility | $8,512.20 | $9,458.00 | $17,400.00 | |
United
| Facility | $11,155.00 | $11,155.00 | $11,155.00 |