| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $207.34 | $2,084.01 | $9,727.00 | |
Medcost
| Facility | $178.01 | $364.70 | $1,440.41 | |
Medcost
| Facility | 50 | $372.00 | $1,451.36 | $2,160.62 |
United
| Facility | $225.00 | $1,221.00 | $3,585.00 |