| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $256.47 | $5,644.00 | $9,842.00 | |
Aetna
| Facility | 50 | $5,147.00 | $13,134.00 | $13,134.00 |
Horizon BCBS
| Facility | $8,385.14 | $8,385.14 | $17,029.74 | |
United
| Facility | $5,378.00 | $8,305.00 | $14,121.00 |