| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,288.25 | $2,630.27 | $6,606.93 | |
Aetna
| Professional | $3,890.45 | $6,309.57 | $6,606.93 | |
Medica
| Facility | $223.87 | $1,318.26 | $2,691.53 | |
United
| Facility | $354.81 | $1,318.26 | $2,630.27 |