| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,737.80 | $6,309.57 | $10,715.19 | |
Aetna
| Facility | 50 | $1,548.82 | $5,128.61 | $8,511.38 |
Horizon BCBS
| Facility | $14,454.40 | $22,387.21 | $35,481.34 | |
United
| Facility | $3,630.78 | $7,762.47 | $15,135.61 |