| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,000.00 | $3,684.00 | $18,600.00 | |
Aetna
| Professional | $825.00 | $825.00 | $825.00 | |
Medica
| Facility | $350.00 | $866.25 | $5,833.89 | |
United
| Facility | $350.00 | $1,760.00 | $6,155.68 |