| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $176.69 | $176.69 | $8,500.00 | |
Aetna
| Professional | $172.59 | $241.81 | $265.89 | |
Medica
| Facility | $50.76 | $176.69 | $251.46 | |
Medica
| Professional | $265.98 | $463.05 | $718.67 | |
United
| Professional | $265.98 | $470.78 | $652.69 |