| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $832.85 | $832.85 | $8,500.00 | |
Aetna
| Facility | 52 | $416.43 | $416.43 | $416.43 |
Medica
| Facility | $783.19 | $1,082.71 | $1,803.58 | |
United
| Facility | $681.00 | $681.00 | $1,978.00 |