| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,738.68 | $7,368.87 | $16,467.00 | |
Medcost
| Facility | $2,532.86 | $3,627.28 | $6,131.30 | |
Medcost
| Facility | AS | $373.38 | $430.59 | $700.04 |
United
| Facility | $659.00 | $6,107.00 | $8,818.00 |