| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,691.53 | $8,912.51 | $20,892.96 | |
Aetna
| Facility | 50 | $2,630.27 | $7,762.47 | $25,703.96 |
Anthem BCBS
| Facility | $8,912.51 | $20,417.38 | $31,622.78 | |
United
| Facility | $7,244.36 | $11,220.18 | $18,620.87 |