| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,234.00 | $3,795.64 | $7,119.04 | |
Aetna
| Professional | $126.00 | $126.00 | $430.00 | |
Medica
| Facility | $126.00 | $1,607.00 | $2,338.00 | |
United
| Facility | $1,026.00 | $1,607.00 | $1,966.00 |