| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $400.64 | $400.64 | $600.96 | |
Aetna
| Professional | $400.64 | $400.64 | $400.64 | |
Medica
| Facility | $375.67 | $473.76 | $1,108.35 | |
Medica
| Professional | $405.02 | $503.17 | $667.33 | |
United
| Professional | $405.02 | $503.17 | $743.84 |