| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $688.00 | $1,386.00 | $7,954.00 | |
Aetna
| Professional | $688.00 | $688.00 | $688.00 | |
Anthem BCBS
| Facility | $4,097.10 | $27,462.00 | $56,650.00 | |
United
| Facility | $1,403.00 | $7,104.00 | $28,128.00 |