| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $50.00 | $452.00 | $1,104.00 | |
Aetna
| Professional | $50.00 | $133.03 | $167.28 | |
Horizon BCBS
| Professional | $382.50 | $450.00 | $450.00 | |
United
| Professional | $111.40 | $111.40 | $111.40 |