| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $46.75 | $46.75 | $46.75 | |
Aetna
| Professional | $37.95 | $45.65 | $46.75 | |
Horizon BCBS
| Facility | $8,702.00 | $13,785.00 | $13,785.00 | |
Horizon BCBS
| Professional | $46.75 | $46.75 | $46.75 |