| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,419.37 | $16,467.00 | $45,578.70 | |
Medcost
| Facility | $1,078.54 | $1,419.37 | $2,478.28 | |
Medcost
| Facility | AS | $163.60 | $191.24 | $264.13 |
United
| Facility | $659.00 | $6,107.00 | $8,818.00 |