| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,295.08 | $2,916.48 | $16,467.00 | |
Medcost
| Facility | $1,048.65 | $1,405.40 | $2,409.73 | |
Medcost
| Facility | AS | $167.86 | $191.95 | $277.07 |
United
| Facility | $3,340.00 | $21,721.00 | $33,299.00 |