| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,253.28 | $2,822.71 | $16,467.00 | |
Medcost
| Facility | $1,018.41 | $1,356.47 | $2,334.23 | |
Medcost
| Facility | AS | $165.76 | $185.32 | $268.16 |
United
| Facility | $3,028.00 | $19,627.00 | $25,620.00 |