| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,277.18 | $5,571.00 | $10,371.76 | |
Aetna
| Facility | 50 | $3,208.61 | $7,762.00 | $11,833.50 |
Horizon BCBS
| Facility | $23,264.28 | $23,264.28 | $47,248.43 | |
United
| Facility | $5,682.00 | $10,536.00 | $23,291.00 |