| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,365.16 | $6,025.60 | $10,715.19 | |
Aetna
| Facility | 50 | $9,549.93 | $9,549.93 | $9,549.93 |
Horizon BCBS
| Facility | $3,981.07 | $6,606.93 | $10,000.00 | |
United
| Facility | $2,951.21 | $6,606.93 | $10,964.78 |