| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,065.94 | $3,684.00 | $18,600.00 | |
Medica
| Facility | $1,047.72 | $1,522.52 | $17,449.59 | |
Medica
| Facility | AS | $431.29 | $431.29 | $431.29 |
United
| Facility | $1,960.00 | $9,469.00 | $20,190.00 |