| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $174.51 | $174.51 | $8,500.00 | |
Aetna
| Professional | $174.09 | $241.12 | $268.06 | |
Medica
| Facility | $174.51 | $308.50 | $422.87 | |
Medica
| Professional | $272.83 | $469.86 | $670.78 | |
United
| Professional | $272.83 | $475.63 | $559.58 |