| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $830.51 | $12,461.73 | $24,064.99 | |
Anthem BCBS
| Facility | $4,800.00 | $19,595.20 | $27,445.62 | |
CareSource
| Facility | $823.79 | $1,130.70 | $1,696.05 | |
United
| Facility | $4,472.00 | $10,113.00 | $15,750.00 |