| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,065.50 | $6,798.51 | $16,467.00 | |
Medcost
| Facility | $2,296.00 | $2,997.74 | $5,177.55 | |
Medcost
| Facility | 80 | $459.20 | $553.60 | $922.66 |
United
| Facility | $454.00 | $6,074.00 | $8,818.00 |