| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,850.74 | $3,633.34 | $16,467.00 | |
Medcost
| Facility | $1,395.46 | $2,022.73 | $3,002.64 | |
Medcost
| Facility | AS | $243.88 | $283.18 | $345.17 |
United
| Facility | $659.00 | $6,107.00 | $8,818.00 |