| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,200.00 | $3,909.00 | $12,600.00 | |
Aetna
| Professional | $3,683.00 | $5,946.00 | $6,422.00 | |
Medica
| Facility | $1,157.00 | $4,424.00 | $7,214.89 | |
United
| Facility | $1,157.00 | $4,424.00 | $7,077.94 |