| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $884.34 | $5,843.00 | $10,882.00 | |
AmeriHealth
| Facility | $11,522.50 | $11,522.50 | $11,522.50 | |
Horizon BCBS
| Facility | $28,306.58 | $28,306.58 | $31,281.82 | |
United
| Facility | $6,624.00 | $10,549.00 | $23,535.00 |