| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,064.44 | $2,134.64 | $20,243.00 | |
Aetna
| Facility | 52 | $532.22 | $532.22 | $1,067.32 |
Aetna
| Facility | 53 | $212.89 | $212.89 | $426.93 |
Medcost
| Facility | $804.94 | $1,082.89 | $1,758.03 | |
Medcost
| Facility | 80 | $204.46 | $216.58 | $315.81 |
United
| Facility | $2,912.00 | $16,959.00 | $23,485.00 |