| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $100.00 | $3,313.74 | $3,637.84 | |
Aetna
| Facility | 52 | $1,306.84 | $1,818.92 | $1,818.92 |
Anthem BCBS
| Facility | $3,476.90 | $9,132.04 | $17,364.89 | |
United
| Facility | $972.00 | $4,574.00 | $11,155.00 |