| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $5,011.87 | $5,011.87 | $8,511.38 | |
Medica
| Facility | $4,466.84 | $4,466.84 | $4,466.84 | |
United
| Facility | $1,148.15 | $2,041.74 | $4,677.35 | |
United
| Professional | $1,000.00 | $1,445.44 | $1,819.70 |