| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $119.01 | $280.83 | $3,442.61 | |
Aetna
| Facility | 50 | $6,022.12 | $6,022.12 | $6,022.12 |
Ambetter
| Professional | 50 | $170.76 | $170.76 | $170.76 |
Anthem BCBS
| Professional | 50 | $217.41 | $392.16 | $758.74 |
United
| Facility | $3,360.00 | $3,360.00 | $7,448.00 |