| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $589.00 | $2,508.00 | $7,500.00 | |
Aetna
| Facility | 50 | $609.50 | $1,438.00 | $34,555.37 |
Medica
| Facility | $183.73 | $302.14 | $2,490.86 | |
United
| Facility | $100.00 | $610.00 | $1,883.00 |