| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,754.23 | $6,760.83 | $11,748.98 | |
AmeriHealth
| Facility | $3,890.45 | $3,890.45 | $3,890.45 | |
Horizon BCBS
| Facility | $12,022.64 | $18,620.87 | $29,512.09 | |
United
| Facility | $4,786.30 | $10,000.00 | $25,118.86 |