| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,009.00 | $20,053.70 | $29,022.50 | |
AmeriHealth
| Facility | $183,794.65 | $183,794.65 | $183,794.65 | |
Emblem Health
| Facility | $4,817.00 | $4,817.00 | $4,817.00 | |
Horizon BCBS
| Facility | $1,998.00 | $3,154.00 | $7,020.00 | |
United
| Facility | $6,098.00 | $18,065.00 | $29,622.16 |