| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $629.37 | $5,441.00 | $11,298.00 | |
Aetna
| Facility | 50 | $2,536.92 | $7,458.00 | $11,087.55 |
Horizon BCBS
| Facility | $7,761.00 | $9,309.76 | $20,188.08 | |
United
| Facility | $5,378.00 | $8,305.00 | $14,121.00 |