| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $653.36 | $5,874.00 | $11,557.00 | |
AmeriHealth
| Facility | $11,049.03 | $11,049.03 | $11,049.03 | |
Horizon BCBS
| Facility | $17,367.83 | $17,367.83 | $17,367.83 | |
United
| Facility | $5,682.00 | $10,536.00 | $23,291.00 |