| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $223.51 | $223.51 | $8,500.00 | |
Aetna
| Professional | $223.51 | $223.51 | $308.83 | |
Medica
| Facility | $223.51 | $223.51 | $670.53 | |
Medica
| Professional | $365.51 | $623.94 | $859.17 | |
United
| Professional | $349.35 | $618.35 | $859.17 |