| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $830.86 | $830.86 | $10,000.00 | |
Aetna
| Professional | $830.86 | $830.86 | $958.96 | |
Medica
| Facility | $330.21 | $830.86 | $2,492.58 | |
Medica
| Professional | $1,195.45 | $1,839.16 | $3,069.34 | |
United
| Facility | $11,061.72 | $11,061.72 | $11,061.72 | |
United
| Professional | $1,103.50 | $2,213.39 | $3,069.34 |