| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,009.00 | $11,552.10 | $17,427.40 | |
AmeriHealth
| Facility | $16,144.43 | $16,144.43 | $16,144.43 | |
Emblem Health
| Facility | $4,817.00 | $4,817.00 | $4,817.00 | |
Horizon BCBS
| Facility | $1,998.00 | $3,154.00 | $6,429.00 | |
United
| Facility | $6,098.00 | $16,813.00 | $19,529.00 |