| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,581.75 | $5,343.85 | $9,559.00 | |
Aetna
| Facility | 50 | $6,382.03 | $6,382.03 | $6,382.03 |
Anthem BCBS
| Facility | $5,214.00 | $9,678.00 | $12,904.00 | |
United
| Facility | $5,325.00 | $8,250.00 | $11,880.00 |