| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,359.36 | $6,606.71 | $16,467.00 | |
Medcost
| Facility | $1,789.81 | $2,752.63 | $5,468.16 | |
Medcost
| Facility | AS | $263.11 | $305.05 | $627.64 |
United
| Facility | $659.00 | $6,107.00 | $8,818.00 |