| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $169.06 | $5,845.00 | $10,202.00 | |
Aetna
| Facility | 50 | $1,609.00 | $4,295.97 | $10,665.00 |
Horizon BCBS
| Facility | $7,472.53 | $8,633.08 | $17,094.68 | |
United
| Facility | $4,415.00 | $7,250.00 | $10,536.00 |