| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,635.75 | $6,073.00 | $12,016.91 | |
Aetna
| Facility | 22 | $15,777.91 | $15,777.91 | $15,777.91 |
Horizon BCBS
| Facility | $12,999.74 | $14,184.51 | $28,807.94 | |
United
| Facility | $5,682.00 | $10,536.00 | $23,291.00 |