| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $712.80 | $4,516.00 | $10,202.00 | |
Aetna
| Facility | 54 | $534.60 | $534.60 | $639.64 |
Horizon BCBS
| Facility | $3,565.92 | $6,905.69 | $7,902.25 | |
United
| Facility | $1,529.00 | $3,352.00 | $10,536.00 |