| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,321.87 | $6,550.94 | $16,467.00 | |
Medcost
| Facility | $2,488.52 | $3,335.00 | $5,730.05 | |
Medcost
| Facility | AS | $448.57 | $466.90 | $717.69 |
United
| Facility | $659.00 | $6,107.00 | $8,818.00 |