| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,675.49 | $3,337.52 | $16,467.00 | |
Medcost
| Facility | $1,309.69 | $1,888.73 | $2,746.69 | |
Medcost
| Facility | AS | $225.30 | $264.42 | $334.31 |
United
| Facility | $2,284.00 | $6,074.00 | $8,973.00 |