| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $882.00 | $3,683.00 | $7,500.00 | |
Medica
| Facility | $328.47 | $503.91 | $1,636.46 | |
Medica
| Facility | AS | $86.91 | $163.65 | $163.65 |
United
| Facility | $139.00 | $610.00 | $1,883.00 |