| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $992.72 | $1,963.28 | $16,467.00 | |
Medcost
| Facility | $755.54 | $1,026.95 | $1,716.27 | |
Medcost
| Facility | AS | $134.44 | $139.58 | $219.66 |
United
| Facility | $2,284.00 | $6,074.00 | $8,973.00 |