| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,057.61 | $9,636.31 | $10,193.09 | |
Medcost
| Facility | $942.15 | $1,361.50 | $1,967.38 | |
Medcost
| Facility | AS | $159.76 | $211.12 | $262.36 |
United
| Facility | $659.00 | $6,107.00 | $8,818.00 |