| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $22.91 | $22.91 | $753.00 | |
Aetna
| Professional | $22.91 | $42.03 | $51.46 | |
Horizon BCBS
| Facility | $3,893.09 | $4,042.19 | $4,595.84 | |
Horizon BCBS
| Professional | $42.81 | $46.86 | $51.86 |