| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $32.97 | $2,634.00 | $8,419.00 | |
Aetna
| Facility | 50 | $748.12 | $2,741.00 | $2,741.00 |
Horizon BCBS
| Facility | $527.73 | $583.20 | $1,184.44 | |
United
| Facility | $1,341.00 | $2,626.00 | $5,864.00 |