| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,300.00 | $3,909.00 | $18,600.00 | |
Medica
| Facility | $1,723.87 | $6,081.89 | $8,565.35 | |
Medica
| Facility | 62 | $15,385.09 | $15,385.09 | $15,385.09 |
United
| Facility | $350.00 | $1,760.00 | $6,155.68 |