| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $780.05 | $5,982.00 | $10,692.00 | |
Aetna
| Facility | 50 | $6,518.07 | $8,246.00 | $14,467.50 |
Horizon BCBS
| Facility | $6,923.95 | $8,263.39 | $16,362.64 | |
United
| Facility | $3,885.00 | $8,043.00 | $14,048.00 |