| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $882.00 | $3,683.00 | $7,500.00 | |
Medica
| Facility | $192.28 | $274.95 | $5,849.00 | |
Medica
| Facility | AS | $43.74 | $83.11 | $83.11 |
United
| Facility | $1,157.00 | $4,424.00 | $7,077.94 |