| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $268.51 | $4,551.00 | $9,784.00 | |
Aetna
| Facility | 52 | $134.26 | $134.26 | $219.71 |
Cigna
| Facility | $3,438.00 | $3,438.00 | $3,438.00 | |
Horizon BCBS
| Facility | $4,173.32 | $4,611.96 | $8,795.46 | |
United
| Facility | $3,204.00 | $5,225.00 | $10,536.00 |