| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $326.73 | $6,396.00 | $11,260.00 | |
Aetna
| Facility | 50 | $6,692.00 | $6,692.00 | $10,719.69 |
Horizon BCBS
| Facility | $4,019.14 | $4,796.64 | $10,799.81 | |
United
| Facility | $4,415.00 | $7,250.00 | $10,536.00 |