| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $174.51 | $174.51 | $8,500.00 | |
Aetna
| Professional | $156.74 | $241.12 | $252.75 | |
Medica
| Facility | $174.51 | $305.68 | $419.08 | |
Medica
| Professional | $272.83 | $467.01 | $670.78 | |
United
| Professional | $268.99 | $403.49 | $559.58 |