| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,118.00 | $7,515.00 | $11,798.00 | |
Aetna
| Professional | $11,103.76 | $11,103.76 | $11,103.76 | |
Horizon BCBS
| Facility | $10,999.06 | $22,888.08 | $26,025.12 | |
United
| Facility | $4,415.00 | $7,250.00 | $10,536.00 |