| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $100.00 | $2,666.32 | $9,859.00 | |
Aetna
| Facility | 52 | $676.12 | $1,333.16 | $1,333.16 |
Anthem BCBS
| Facility | $3,476.90 | $9,132.04 | $17,364.89 | |
United
| Facility | $854.00 | $4,487.00 | $9,949.00 |