| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,386.00 | $2,841.24 | $16,042.00 | |
Anthem BCBS
| Facility | $4,800.00 | $19,595.20 | $27,445.62 | |
CareSource
| Facility | $1,714.83 | $2,353.69 | $3,530.54 | |
United
| Facility | $4,472.00 | $10,113.00 | $15,750.00 |