| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $348.13 | $348.13 | $832.82 | |
Aetna
| Professional | $348.13 | $348.13 | $488.00 | |
Medica
| Facility | $348.13 | $591.82 | $2,204.14 | |
Medica
| Professional | $525.46 | $667.89 | $1,030.85 | |
United
| Professional | $525.46 | $616.51 | $1,027.52 |