| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $6,638.67 | $9,235.90 | $16,851.72 | |
Aetna
| Facility | 52 | $351.50 | $8,837.32 | $8,837.32 |
Medica
| Facility | $702.99 | $1,147.77 | $7,219.44 | |
United
| Facility | $3,240.00 | $3,240.00 | $3,240.00 |