| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $958.16 | $2,156.50 | $16,467.00 | |
Medcost
| Facility | $856.20 | $1,281.34 | $1,783.65 | |
Medcost
| Facility | AS | $151.25 | $191.80 | $218.86 |
United
| Facility | $659.00 | $6,107.00 | $8,818.00 |