| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,862.82 | $9,062.00 | $18,276.00 | |
Medcost
| Facility | $1,415.51 | $1,876.64 | $3,083.62 | |
Medcost
| Facility | 80 | $359.88 | $365.86 | $552.91 |
Medcost
| Facility | AS | $214.32 | $256.10 | $353.40 |
United
| Facility | $2,284.00 | $6,074.00 | $8,973.00 |