| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,009.00 | $17,619.30 | $25,499.30 | |
AmeriHealth
| Facility | $18,408.15 | $18,408.15 | $18,408.15 | |
Emblem Health
| Facility | $4,817.00 | $4,817.00 | $4,817.00 | |
Horizon BCBS
| Facility | $1,998.00 | $3,050.00 | $7,020.00 | |
United
| Facility | $6,098.00 | $18,065.00 | $26,026.23 |