| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $912.01 | $2,570.40 | $6,606.93 | |
Medica
| Facility | $275.42 | $436.52 | $3,981.07 | |
Medica
| Facility | 52 | $18,197.01 | $18,197.01 | $18,197.01 |
United
| Facility | $575.44 | $2,187.76 | $4,168.69 |