| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $902.00 | $7,586.00 | $11,814.76 | |
Aetna
| Facility | 50 | $1,918.37 | $8,531.71 | $13,290.40 |
Anthem BCBS
| Facility | $9,078.00 | $14,635.00 | $18,294.00 | |
United
| Facility | $6,943.00 | $10,797.00 | $18,470.00 |