| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,611.87 | $4,540.00 | $10,871.00 | |
Aetna
| Facility | 52 | $805.94 | $805.94 | $1,574.69 |
Horizon BCBS
| Facility | $1,080.00 | $1,080.00 | $1,641.00 | |
United
| Facility | $1,423.00 | $3,961.00 | $9,513.00 |