| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $259.73 | $5,009.00 | $9,284.00 | |
AmeriHealth
| Facility | $19,887.45 | $19,887.45 | $19,887.45 | |
Horizon BCBS
| Facility | $8,263.39 | $9,755.03 | $18,605.30 | |
United
| Facility | $5,378.00 | $8,305.00 | $14,121.00 |