| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $382.86 | $3,678.00 | $9,784.00 | |
Aetna
| Facility | 54 | $287.14 | $287.14 | $378.06 |
Horizon BCBS
| Facility | $3,565.92 | $3,890.91 | $4,423.85 | |
United
| Facility | $3,705.00 | $5,523.00 | $9,152.00 |