| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,965.62 | $11,025.00 | $22,776.00 | |
Medcost
| Facility | $1,584.40 | $2,063.90 | $3,545.21 | |
Medcost
| Facility | 80 | $360.20 | $394.85 | $586.23 |
United
| Facility | $659.00 | $6,107.00 | $8,818.00 |