| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $2,480.00 | $2,480.00 | $2,480.00 | |
Emblem Health
| Professional | $1,799.03 | $2,116.50 | $2,490.00 | |
Horizon BCBS
| Facility | $2,066.69 | $13,785.00 | $13,785.00 | |
Horizon BCBS
| Professional | $2,116.50 | $2,116.50 | $2,116.50 |