| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $92.06 | $92.06 | $92.06 | |
Aetna
| Professional | $92.06 | $174.06 | $196.05 | |
Horizon BCBS
| Facility | $3,369.74 | $3,704.57 | $7,708.88 | |
Horizon BCBS
| Professional | $166.69 | $196.10 | $201.93 |