| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $537.03 | $1,071.52 | $3,630.78 | |
Aetna
| Professional | $457.09 | $537.03 | $676.08 | |
Medica
| Facility | $467.74 | $707.95 | $1,288.25 | |
Medica
| Professional | $295.12 | $295.12 | $3,467.37 | |
United
| Facility | $630.96 | $707.95 | $831.76 | |
United
| Professional | $295.12 | $295.12 | $416.87 |