| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $870.17 | $6,016.00 | $11,193.00 | |
Aetna
| Facility | 50 | $870.17 | $4,042.00 | $4,042.00 |
Horizon BCBS
| Facility | $14,530.69 | $18,026.64 | $32,200.55 | |
United
| Facility | $5,682.00 | $9,969.00 | $19,696.00 |