| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $100.00 | $5,086.18 | $17,391.34 | |
Aetna
| Facility | 52 | $2,543.10 | $2,543.10 | $2,543.10 |
Anthem BCBS
| Facility | $8,512.20 | $17,300.00 | $28,708.24 | |
United
| Facility | $9,565.00 | $9,565.00 | $9,565.00 |