| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,500.00 | $7,655.00 | $13,151.00 | |
Aetna
| Professional | $3,600.00 | $3,600.00 | $7,655.00 | |
Medica
| Facility | $55.00 | $852.00 | $2,746.00 | |
United
| Facility | $525.00 | $1,353.00 | $2,793.00 |