| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,196.94 | $4,961.74 | $16,467.00 | |
Medcost
| Facility | $1,835.72 | $2,454.00 | $4,236.85 | |
Medcost
| Facility | AS | $298.72 | $343.56 | $528.36 |
United
| Facility | $659.00 | $6,107.00 | $8,818.00 |