| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $758.12 | $4,846.00 | $16,857.34 | |
Anthem BCBS
| Facility | $4,800.00 | $19,595.20 | $27,445.62 | |
CareSource
| Facility | $786.35 | $1,036.13 | $1,554.20 | |
United
| Facility | $4,472.00 | $10,113.00 | $15,750.00 |