| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $100.00 | $473.95 | $14,072.82 | |
Aetna
| Facility | 50 | $1,222.30 | $4,588.50 | $4,588.50 |
Anthem BCBS
| Facility | $8,512.20 | $9,458.00 | $17,400.00 | |
United
| Facility | $9,949.00 | $9,949.00 | $9,949.00 |