| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $312.02 | $5,109.00 | $11,298.00 | |
Aetna
| Facility | 50 | $2,935.50 | $5,332.00 | $7,841.00 |
Horizon BCBS
| Facility | $13,217.38 | $15,854.99 | $32,200.55 | |
United
| Facility | $5,682.00 | $9,969.00 | $19,696.00 |