| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $537.79 | $6,016.00 | $11,298.00 | |
Aetna
| Facility | 50 | $4,249.32 | $4,249.32 | $4,249.32 |
Horizon BCBS
| Facility | $4,728.33 | $5,671.88 | $12,299.42 | |
United
| Facility | $2,122.00 | $5,771.00 | $10,334.00 |