| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $295.12 | $7,943.28 | $16,595.87 | |
Medcost
| Professional | $501.19 | $501.19 | $501.19 | |
Medcost
| Facility | $251.19 | $309.03 | $416.87 | |
United
| Facility | $4,073.80 | $12,882.50 | $23,442.29 |