| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $552.82 | $5,982.00 | $10,871.00 | |
Aetna
| Facility | 53 | $110.56 | $110.56 | $172.40 |
Cigna
| Facility | $19,351.00 | $26,155.00 | $34,609.00 | |
Horizon BCBS
| Facility | $23,318.14 | $28,928.30 | $55,173.54 | |
United
| Facility | $6,435.00 | $12,315.00 | $63,097.00 |