| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $100.00 | $3,491.19 | $9,859.00 | |
Aetna
| Facility | 52 | $696.43 | $1,745.60 | $1,745.60 |
Anthem BCBS
| Facility | $10,334.70 | $15,674.40 | $29,801.00 | |
United
| Facility | $12,629.00 | $12,629.00 | $12,629.00 |