| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $224.97 | $224.97 | $8,500.00 | |
Aetna
| Professional | $224.97 | $224.97 | $671.42 | |
Medica
| Facility | $224.97 | $674.91 | $1,186.67 | |
Medica
| Professional | $662.61 | $1,104.30 | $1,557.45 | |
United
| Professional | $659.26 | $1,121.06 | $1,408.67 |