| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,497.75 | $3,697.48 | $16,467.00 | |
Medcost
| Facility | $1,283.47 | $1,795.75 | $3,048.76 | |
Medcost
| Facility | AS | $218.19 | $251.41 | $351.26 |
United
| Facility | $659.00 | $6,107.00 | $8,818.00 |