| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $182.40 | $182.40 | $8,500.00 | |
Aetna
| Professional | $182.40 | $182.40 | $252.12 | |
Medica
| Facility | $182.40 | $182.40 | $547.20 | |
Medica
| Professional | $314.33 | $509.17 | $701.12 | |
United
| Professional | $298.27 | $542.32 | $701.12 |