| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $693.21 | $5,238.00 | $11,844.84 | |
Aetna
| Facility | 50 | $3,103.83 | $7,825.28 | $24,678.49 |
Anthem BCBS
| Facility | $8,512.20 | $9,458.00 | $17,400.00 | |
United
| Facility | $12,399.00 | $12,399.00 | $12,399.00 |