| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,778.28 | $4,897.79 | $10,715.19 | |
Aetna
| Facility | 50 | $2,089.30 | $4,265.80 | $8,128.31 |
Horizon BCBS
| Facility | $7,943.28 | $12,302.69 | $19,498.45 | |
United
| Facility | $3,630.78 | $7,585.78 | $15,135.61 |