| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,466.84 | $8,511.38 | $12,302.69 | |
Aetna
| Facility | 50 | $12,882.50 | $12,882.50 | $12,882.50 |
Horizon BCBS
| Facility | $36,307.81 | $58,884.37 | $91,201.08 | |
United
| Facility | $5,128.61 | $10,715.19 | $29,512.09 |