| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,862.00 | $7,629.00 | $18,588.59 | |
Aetna
| Facility | 50 | $2,243.14 | $6,076.25 | $29,329.50 |
Anthem BCBS
| Facility | $9,716.00 | $16,049.80 | $27,434.00 | |
United
| Facility | $6,943.00 | $10,797.00 | $18,470.00 |