| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,090.00 | $8,031.00 | $13,387.00 | |
Aetna
| Facility | 50 | $9,294.29 | $9,294.29 | $9,294.29 |
Anthem BCBS
| Facility | $8,633.00 | $15,243.32 | $23,168.00 | |
United
| Facility | $5,944.00 | $10,417.00 | $16,323.00 |