| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,067.21 | $9,062.00 | $16,467.00 | |
Medcost
| Facility | $1,570.82 | $2,072.36 | $3,391.53 | |
Medcost
| Facility | 80 | $400.06 | $404.56 | $610.45 |
Medcost
| Facility | AS | $237.82 | $283.19 | $390.84 |
United
| Facility | $659.00 | $6,107.00 | $8,818.00 |