| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $711.68 | $1,408.34 | $16,467.00 | |
Medcost
| Facility | $485.02 | $697.87 | $1,231.09 | |
Medcost
| Facility | 80 | $100.00 | $135.96 | $209.50 |
Medcost
| Facility | AS | $70.00 | $81.89 | $146.65 |
United
| Facility | $659.00 | $6,107.00 | $8,818.00 |