| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,943.00 | $8,031.00 | $13,387.00 | |
Aetna
| Facility | 50 | $3,166.57 | $9,294.29 | $22,703.42 |
Anthem BCBS
| Facility | $9,078.00 | $14,635.00 | $18,294.00 | |
United
| Facility | $5,944.00 | $10,417.00 | $16,323.00 |