| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $691.83 | $776.25 | $10,000.00 | |
Aetna
| Professional | $691.83 | $776.25 | $1,174.90 | |
Medica
| Facility | $691.83 | $1,258.93 | $2,089.30 | |
Medica
| Professional | $741.31 | $1,148.15 | $2,137.96 | |
United
| Facility | $1,819.70 | $2,041.74 | $2,041.74 | |
United
| Professional | $794.33 | $1,148.15 | $2,290.87 |