| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,754.23 | $7,943.28 | $12,022.64 | |
Aetna
| Facility | 50 | $12,022.64 | $12,589.25 | $12,589.25 |
Horizon BCBS
| Facility | $18,620.87 | $29,512.09 | $46,773.51 | |
United
| Facility | $4,570.88 | $9,120.11 | $21,379.62 |