| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,290.00 | $2,290.00 | $4,338.00 | |
Aetna
| Professional | $5,391.00 | $5,391.00 | $5,391.00 | |
Medica
| Facility | $2,714.00 | $2,714.00 | $2,714.00 | |
United
| Facility | $2,714.00 | $2,714.00 | $2,714.00 |