| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $457.09 | $1,000.00 | $4,897.79 | |
Anthem BCBS
| Facility | $4,265.80 | $8,709.64 | $11,220.18 | |
CareSource
| Facility | $389.05 | $426.58 | $457.09 | |
United
| Facility | $1,412.54 | $5,754.40 | $12,022.64 |