| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,570.88 | $8,511.38 | $19,952.62 | |
Aetna
| Facility | 50 | $9,332.54 | $9,332.54 | $9,332.54 |
Anthem BCBS
| Facility | $8,709.64 | $16,982.44 | $19,952.62 | |
United
| Facility | $6,456.54 | $10,471.29 | $16,218.10 |