| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,887.76 | $9,062.00 | $16,467.00 | |
Medcost
| Facility | $4,005.60 | $5,027.28 | $9,568.01 | |
Medcost
| Facility | 80 | $956.40 | $982.53 | $1,486.92 |
United
| Facility | $659.00 | $6,107.00 | $8,818.00 |