| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,621.81 | $4,073.80 | $8,128.31 | |
Aetna
| Professional | $89.13 | $177.83 | $3,630.78 | |
Medica
| Facility | $54.95 | $436.52 | $1,698.24 | |
United
| Facility | $173.78 | $416.87 | $1,778.28 |