| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $100.00 | $1,409.14 | $10,184.40 | |
Aetna
| Facility | 50 | $11,827.26 | $11,827.26 | $11,827.26 |
Anthem BCBS
| Facility | $9,905.40 | $11,006.00 | $17,487.00 | |
United
| Facility | $11,155.00 | $11,155.00 | $11,155.00 |