| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,009.00 | $16,531.30 | $24,323.00 | |
AmeriHealth
| Facility | $4,205.00 | $4,205.00 | $4,205.00 | |
Emblem Health
| Facility | $4,817.00 | $4,817.00 | $4,817.00 | |
Horizon BCBS
| Facility | $1,972.00 | $3,050.00 | $7,020.00 | |
United
| Facility | $6,909.00 | $10,040.82 | $23,750.85 |