| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $882.10 | $882.10 | $3,373.49 | |
Aetna
| Professional | $687.10 | $882.10 | $1,052.08 | |
Horizon BCBS
| Facility | $892.84 | $995.15 | $2,055.83 | |
Horizon BCBS
| Professional | $4.25 | $5.00 | $5.00 |