| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $948.79 | $2,141.80 | $16,467.00 | |
Medcost
| Facility | $822.99 | $1,050.34 | $1,768.41 | |
Medcost
| Facility | AS | $147.05 | $147.05 | $203.47 |
United
| Facility | $659.00 | $6,107.00 | $8,818.00 |