| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $180.27 | $180.27 | $8,500.00 | |
Aetna
| Professional | $80.92 | $180.27 | $272.48 | |
Medica
| Facility | $180.27 | $195.90 | $237.04 | |
Medica
| Professional | $187.01 | $453.75 | $668.30 | |
United
| Professional | $164.17 | $319.26 | $533.82 |