| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,949.84 | $6,918.31 | $10,964.78 | |
Aetna
| Facility | 50 | $6,309.57 | $7,585.78 | $8,912.51 |
Horizon BCBS
| Facility | $10,964.78 | $16,218.10 | $25,703.96 | |
United
| Facility | $2,951.21 | $6,606.93 | $10,964.78 |