| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $218.17 | $483.62 | $16,467.00 | |
Medcost
| Facility | $179.17 | $231.45 | $399.58 | |
Medcost
| Facility | 80 | $45.51 | $45.73 | $65.63 |
United
| Facility | $2,284.00 | $6,074.00 | $8,973.00 |