| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $810.35 | $810.35 | $10,000.00 | |
Aetna
| Professional | $810.35 | $810.35 | $1,120.08 | |
Medica
| Facility | $810.35 | $1,377.60 | $2,431.05 | |
Medica
| Professional | $1,266.74 | $2,262.19 | $3,114.88 | |
United
| Professional | $1,396.62 | $2,296.94 | $3,114.88 |