| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $707.95 | $7,413.10 | $9,120.11 | |
Aetna
| Professional | $371.54 | $3,019.95 | $5,754.40 | |
Medica
| Facility | $251.19 | $2,691.53 | $4,365.16 | |
United
| Facility | $125.89 | $457.09 | $2,041.74 |