| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,852.25 | $9,209.00 | $14,360.00 | |
Aetna
| Facility | 22 | $27,071.92 | $27,071.92 | $27,071.92 |
Horizon BCBS
| Facility | $23,197.59 | $25,311.77 | $51,406.75 | |
United
| Facility | $5,682.00 | $10,536.00 | $23,291.00 |