| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $198.39 | $5,956.00 | $10,692.00 | |
Aetna
| Facility | 50 | $3,463.50 | $5,580.00 | $7,489.24 |
Horizon BCBS
| Facility | $13,581.77 | $13,581.77 | $36,495.49 | |
United
| Facility | $5,378.00 | $8,305.00 | $14,121.00 |