| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $500.00 | $3,576.00 | $7,500.00 | |
Aetna
| Professional | $70.98 | $207.47 | $207.47 | |
Medica
| Facility | $207.47 | $207.47 | $259.33 | |
Medica
| Professional | $165.26 | $225.86 | $647.96 | |
United
| Professional | $204.80 | $231.30 | $324.22 |