| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $198.79 | $4,477.00 | $6,986.00 | |
Aetna
| Facility | 50 | $4,585.50 | $4,585.50 | $9,155.00 |
Horizon BCBS
| Facility | $3,520.85 | $3,747.41 | $7,420.39 | |
United
| Facility | $3,705.00 | $5,265.00 | $10,536.00 |