| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $100.00 | $4,624.50 | $4,624.50 | |
Aetna
| Facility | 52 | $1,172.28 | $2,312.25 | $2,312.25 |
Anthem BCBS
| Facility | $3,476.90 | $9,132.04 | $17,364.89 | |
United
| Facility | $451.00 | $3,360.00 | $7,448.00 |