| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,091.42 | $1,846.02 | $8,500.00 | |
Aetna
| Facility | 50 | $4,744.24 | $14,845.61 | $32,484.06 |
Medica
| Facility | $1,091.42 | $1,538.36 | $3,274.26 | |
Medica
| Facility | 50 | $5,313.07 | $9,093.67 | $10,902.83 |