| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,287.05 | $5,467.00 | $12,237.00 | |
Aetna
| Facility | 52 | $828.68 | $828.68 | $1,292.14 |
Medica
| Facility | $55.00 | $1,763.00 | $4,200.89 | |
United
| Facility | $1,436.00 | $3,096.00 | $5,565.00 |