| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,033.17 | $2,321.31 | $16,467.00 | |
Medcost
| Facility | $848.41 | $1,136.49 | $1,919.39 | |
Medcost
| Facility | AS | $145.18 | $156.99 | $220.52 |
United
| Facility | $659.00 | $6,107.00 | $8,818.00 |