| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,288.25 | $2,630.27 | $6,606.93 | |
Medica
| Facility | $1,621.81 | $5,888.44 | $19,952.62 | |
Medica
| Facility | AS | $741.31 | $741.31 | $741.31 |
United
| Facility | $3,467.37 | $10,715.19 | $20,417.38 |