| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $772.07 | $5,244.00 | $9,950.00 | |
Aetna
| Facility | 54 | $579.04 | $579.04 | $710.42 |
Horizon BCBS
| Facility | $3,139.98 | $3,139.98 | $7,420.39 | |
United
| Facility | $2,354.00 | $3,961.00 | $10,536.00 |