| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $727.10 | $6,986.00 | $13,092.00 | |
Aetna
| Facility | 54 | $545.33 | $545.33 | $740.37 |
Horizon BCBS
| Facility | $5,340.39 | $5,544.92 | $10,574.69 | |
United
| Facility | $3,885.00 | $7,250.00 | $10,536.00 |