| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,426.41 | $4,825.10 | $16,467.00 | |
Medcost
| Facility | $1,887.32 | $2,823.23 | $3,973.71 | |
Medcost
| Facility | 80 | $479.58 | $594.57 | $654.84 |
United
| Facility | $659.00 | $6,107.00 | $8,818.00 |