| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.60 | $30.60 | $30.60 | |
Aetna
| Professional | $24.84 | $29.88 | $30.60 | |
Horizon BCBS
| Facility | $8,702.00 | $13,785.00 | $13,785.00 | |
Horizon BCBS
| Professional | $30.60 | $30.60 | $30.60 |