| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,365.16 | $7,244.36 | $11,748.98 | |
Aetna
| Facility | 50 | $8,912.51 | $8,912.51 | $8,912.51 |
Horizon BCBS
| Facility | $7,762.47 | $12,022.64 | $19,054.61 | |
United
| Facility | $3,388.44 | $7,413.10 | $15,135.61 |