| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $500.33 | $8,084.00 | $12,513.00 | |
Aetna
| Facility | 50 | $9,814.08 | $10,314.54 | $15,364.50 |
Horizon BCBS
| Facility | $22,406.18 | $23,264.28 | $41,289.94 | |
United
| Facility | $5,682.00 | $10,536.00 | $23,291.00 |