| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,102.66 | $2,479.71 | $16,467.00 | |
Medcost
| Facility | $950.37 | $1,212.93 | $2,049.79 | |
Medcost
| Facility | AS | $169.81 | $169.81 | $242.59 |
United
| Facility | $659.00 | $6,107.00 | $8,818.00 |