| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $302.27 | $5,982.00 | $11,260.00 | |
Aetna
| Facility | 50 | $8,762.04 | $8,762.04 | $8,762.04 |
Horizon BCBS
| Facility | $7,233.72 | $7,233.72 | $8,963.70 | |
United
| Facility | $2,300.00 | $5,803.00 | $10,334.00 |