| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,050.54 | $6,450.00 | $11,298.00 | |
AmeriHealth
| Facility | $4,287.50 | $4,287.50 | $4,287.50 | |
Horizon BCBS
| Facility | $8,153.34 | $9,780.39 | $21,208.63 | |
United
| Facility | $5,667.00 | $9,969.00 | $19,696.00 |