| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $229.12 | $510.27 | $16,467.00 | |
Medcost
| Facility | $190.19 | $246.46 | $420.19 | |
Medcost
| Facility | 80 | $47.17 | $48.55 | $69.25 |
United
| Facility | $659.00 | $6,107.00 | $8,818.00 |