| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $484.53 | $4,174.00 | $9,860.00 | |
Aetna
| Facility | 50 | $2,067.00 | $2,763.22 | $7,075.86 |
Horizon BCBS
| Facility | $7,512.98 | $7,761.00 | $17,754.61 | |
United
| Facility | $5,378.00 | $8,305.00 | $14,121.00 |