| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,148.15 | $2,630.27 | $6,606.93 | |
Medica
| Facility | $138.04 | $1,047.13 | $5,888.44 | |
Medica
| Facility | AS | $407.38 | $407.38 | $407.38 |
United
| Facility | $138.04 | $630.96 | $1,659.59 |