| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,217.57 | $2,711.72 | $16,467.00 | |
Medcost
| Facility | $1,015.71 | $1,317.07 | $2,330.00 | |
Medcost
| Facility | AS | $165.76 | $178.78 | $326.20 |
United
| Facility | $659.00 | $6,107.00 | $8,818.00 |