| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $100.00 | $2,503.28 | $9,859.00 | |
Aetna
| Facility | 54 | $1,877.46 | $1,877.46 | $1,877.46 |
Anthem BCBS
| Facility | $1,449.90 | $1,611.00 | $3,700.00 | |
United
| Facility | $9,565.00 | $9,565.00 | $9,565.00 |