| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $389.47 | $3,059.00 | $9,125.00 | |
Aetna
| Facility | 54 | $292.10 | $310.98 | $400.89 |
Horizon BCBS
| Facility | $3,139.98 | $3,139.98 | $8,437.42 | |
United
| Facility | $2,354.00 | $3,961.00 | $10,536.00 |