| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $100.00 | $3,286.75 | $8,965.00 | |
Aetna
| Facility | 52 | $649.38 | $1,643.38 | $1,643.38 |
Anthem BCBS
| Facility | $10,334.70 | $11,483.00 | $21,862.00 | |
United
| Facility | $12,629.00 | $12,629.00 | $12,629.00 |