| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $309.19 | $5,843.00 | $10,202.00 | |
Aetna
| Facility | 50 | $3,682.19 | $4,527.31 | $9,713.45 |
Horizon BCBS
| Facility | $7,884.56 | $15,036.65 | $16,013.10 | |
United
| Facility | $4,415.00 | $7,250.00 | $10,536.00 |