| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $408.76 | $5,644.00 | $9,936.00 | |
Aetna
| Facility | 50 | $5,636.12 | $9,096.00 | $11,709.36 |
Horizon BCBS
| Facility | $7,684.77 | $8,385.14 | $18,183.06 | |
United
| Facility | $5,378.00 | $8,305.00 | $14,121.00 |