| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,290.87 | $4,365.16 | $4,365.16 | |
Aetna
| Professional | $162.18 | $5,370.32 | $5,370.32 | |
Medica
| Facility | $2,691.53 | $2,691.53 | $2,691.53 | |
United
| Facility | $2,691.53 | $2,691.53 | $2,691.53 |