| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,155.19 | $2,987.49 | $16,467.00 | |
Medcost
| Facility | $1,085.68 | $1,490.00 | $2,471.50 | |
Medcost
| Facility | AS | $200.86 | $208.60 | $283.81 |
United
| Facility | $659.00 | $6,107.00 | $8,818.00 |