| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $326.39 | $5,644.61 | $10,882.00 | |
Aetna
| Facility | 52 | $116.58 | $116.58 | $215.39 |
Horizon BCBS
| Facility | $7,884.56 | $7,884.56 | $15,036.65 | |
United
| Facility | $3,885.00 | $7,188.00 | $10,536.00 |