| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,886.00 | $4,747.00 | $12,154.00 | |
Aetna
| Professional | $1,800.00 | $3,281.00 | $7,655.00 | |
Medica
| Facility | $1,663.00 | $3,856.73 | $6,988.00 | |
United
| Facility | $1,779.00 | $3,647.00 | $6,988.00 |