| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $216.54 | $216.54 | $8,500.00 | |
Aetna
| Professional | $216.54 | $321.13 | $321.13 | |
Medica
| Facility | $216.54 | $292.18 | $558.20 | |
Medica
| Professional | $337.23 | $551.83 | $799.97 | |
United
| Facility | $271.00 | $271.00 | $271.00 | |
United
| Professional | $325.89 | $526.28 | $755.54 |