| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $639.37 | $4,895.00 | $8,155.00 | |
Aetna
| Facility | 50 | $2,336.62 | $5,818.06 | $8,556.00 |
Horizon BCBS
| Facility | $7,512.98 | $7,512.98 | $17,754.61 | |
United
| Facility | $5,378.00 | $8,305.00 | $14,121.00 |