| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $348.56 | $4,049.00 | $9,784.00 | |
Aetna
| Facility | 54 | $261.42 | $261.42 | $344.85 |
Horizon BCBS
| Facility | $470.65 | $527.73 | $1,264.67 | |
United
| Facility | $1,529.00 | $3,352.00 | $10,536.00 |