| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,723.70 | $5,982.00 | $12,933.00 | |
Aetna
| Facility | 52 | $416.88 | $425.66 | $4,280.22 |
Horizon BCBS
| Facility | $23,197.59 | $25,311.77 | $54,888.28 | |
United
| Facility | $5,682.00 | $10,536.00 | $23,291.00 |