| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $744.97 | $5,346.00 | $9,784.00 | |
Aetna
| Facility | 50 | $2,672.53 | $5,461.00 | $11,454.00 |
Horizon BCBS
| Facility | $5,671.88 | $10,066.58 | $12,299.42 | |
United
| Facility | $3,885.00 | $7,250.00 | $10,536.00 |