| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $276.74 | $276.74 | $8,500.00 | |
Aetna
| Professional | $276.74 | $276.74 | $335.02 | |
Medica
| Facility | $276.74 | $470.46 | $830.22 | |
Medica
| Professional | $432.71 | $772.60 | $1,063.72 | |
United
| Professional | $477.08 | $822.90 | $1,063.72 |