| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Emblem Health
| Professional | $465.95 | $465.95 | $465.95 | |
Horizon BCBS
| Facility | $6,747.27 | $7,565.70 | $16,980.59 | |
Horizon BCBS
| Professional | $43.95 | $58.68 | $125.79 | |
United
| Professional | $51.43 | $112.96 | $357.32 |