| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,557.00 | $4,828.00 | $6,955.00 | |
Aetna
| Professional | $1,820.00 | $1,820.00 | $2,843.00 | |
Medica
| Facility | $1,751.00 | $3,455.00 | $8,152.00 | |
United
| Facility | $1,751.00 | $3,500.00 | $8,152.00 |