| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $281.95 | $5,695.00 | $10,202.00 | |
Aetna
| Facility | 50 | $5,874.00 | $10,214.34 | $16,165.50 |
Horizon BCBS
| Facility | $4,024.24 | $5,056.35 | $9,643.75 | |
United
| Facility | $3,705.00 | $5,265.00 | $10,536.00 |