| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $730.21 | $730.21 | $730.21 | |
Medica
| Facility | $115.78 | $249.39 | $866.88 | |
Medica
| Professional | $187.45 | $340.82 | $6,299.47 | |
United
| Professional | $172.51 | $323.77 | $413.17 |