| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,175.00 | $7,365.00 | $13,151.00 | |
Aetna
| Facility | 52 | $126.42 | $126.42 | $167.17 |
Medica
| Facility | $55.00 | $341.86 | $4,478.00 | |
United
| Facility | $783.00 | $1,743.00 | $8,198.00 |