| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $526.16 | $5,122.00 | $9,950.00 | |
Aetna
| Facility | 50 | $1,967.50 | $4,770.00 | $7,827.65 |
Horizon BCBS
| Facility | $14,030.14 | $16,829.91 | $32,096.34 | |
United
| Facility | $5,378.00 | $8,305.00 | $14,121.00 |