| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $556.65 | $556.65 | $8,500.00 | |
Aetna
| Professional | $354.50 | $556.65 | $556.65 | |
Medica
| Facility | $513.27 | $556.65 | $1,669.95 | |
Medica
| Professional | $870.12 | $1,553.95 | $2,139.71 | |
United
| Professional | $691.56 | $1,655.12 | $2,139.71 |