| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,288.35 | $6,454.70 | $16,467.00 | |
Medcost
| Facility | $2,481.53 | $3,288.35 | $5,648.52 | |
Medcost
| Facility | AS | $425.88 | $446.30 | $672.67 |
United
| Facility | $659.00 | $6,107.00 | $8,818.00 |