| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $24.52 | $4,540.00 | $10,692.00 | |
Aetna
| Facility | 52 | $12.02 | $12.26 | $16.29 |
Horizon BCBS
| Facility | $1,900.21 | $2,591.61 | $4,629.32 | |
United
| Facility | $3,204.00 | $5,225.00 | $10,536.00 |