| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $461.51 | $4,468.00 | $9,784.00 | |
Aetna
| Facility | 54 | $346.13 | $346.13 | $441.98 |
Horizon BCBS
| Facility | $3,139.98 | $3,243.64 | $6,905.69 | |
United
| Facility | $3,705.00 | $5,265.00 | $10,536.00 |