| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $338.84 | $6,025.60 | $16,595.87 | |
Medcost
| Professional | $954.99 | $954.99 | $954.99 | |
Medcost
| Facility | $141.25 | $436.52 | $1,096.48 | |
United
| Facility | $380.19 | $1,202.26 | $3,548.13 |