| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,126.20 | $6,707.00 | $13,092.00 | |
AmeriHealth
| Facility | $1,250.00 | $1,250.00 | $1,250.00 | |
Horizon BCBS
| Facility | $11,606.42 | $11,989.59 | $31,187.56 | |
United
| Facility | $5,682.00 | $9,969.00 | $19,696.00 |