| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,019.95 | $5,011.87 | $10,232.93 | |
Aetna
| Facility | 50 | $6,309.57 | $6,309.57 | $6,309.57 |
Anthem BCBS
| Facility | $7,413.10 | $12,302.69 | $13,803.84 | |
United
| Facility | $5,754.40 | $8,709.64 | $11,748.98 |