| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,105.40 | $6,882.85 | $34,840.68 | |
Aetna
| Facility | 22 | $18,103.31 | $18,103.31 | $18,103.31 |
Anthem BCBS
| Facility | $8,992.79 | $9,992.00 | $19,050.00 | |
United
| Facility | $12,399.00 | $12,399.00 | $12,399.00 |