| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,575.61 | $7,043.06 | $16,467.00 | |
Medcost
| Facility | $2,719.00 | $3,575.61 | $6,144.19 | |
Medcost
| Facility | AS | $411.83 | $492.24 | $785.16 |
United
| Facility | $659.00 | $6,107.00 | $8,818.00 |