| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $312.87 | $616.73 | $16,467.00 | |
Medcost
| Facility | $238.25 | $375.00 | $538.45 | |
Medcost
| Facility | AS | $42.23 | $53.20 | $64.17 |
United
| Facility | $659.00 | $6,107.00 | $8,818.00 |