| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $722.28 | $5,982.00 | $11,208.00 | |
Aetna
| Facility | 50 | $10,351.94 | $10,351.94 | $11,230.00 |
Horizon BCBS
| Facility | $15,715.96 | $15,715.96 | $17,367.83 | |
United
| Facility | $5,378.00 | $8,305.00 | $14,121.00 |