| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $234.84 | $2,269.82 | $9,062.00 | |
Medcost
| Facility | $206.66 | $415.64 | $1,690.63 | |
Medcost
| Facility | 50 | $433.50 | $1,559.82 | $2,535.94 |
United
| Facility | $225.00 | $1,221.00 | $3,585.00 |