| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $567.01 | $7,182.00 | $16,467.00 | |
Medcost
| Facility | $430.85 | $567.01 | $985.49 | |
Medcost
| Facility | AS | $65.33 | $79.03 | $107.26 |
United
| Facility | $659.00 | $6,107.00 | $8,818.00 |