| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $619.05 | $1,515.92 | $9,529.77 | |
Aetna
| Facility | 50 | $10,926.30 | $10,926.30 | $10,926.30 |
Anthem BCBS
| Facility | $1,449.90 | $1,611.00 | $3,700.00 | |
United
| Facility | $9,565.00 | $9,565.00 | $9,565.00 |