| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $627.98 | $3,154.35 | $12,757.39 | |
Aetna
| Professional | $627.98 | $627.98 | $627.98 | |
Anthem BCBS
| Facility | $4,097.10 | $27,462.00 | $30,513.00 | |
United
| Facility | $983.00 | $3,232.00 | $28,128.00 |