| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,048.15 | $1,048.15 | $8,500.00 | |
Aetna
| Facility | 52 | $524.08 | $524.08 | $524.08 |
Medica
| Facility | $1,048.15 | $1,362.60 | $2,790.00 | |
United
| Facility | $1,978.00 | $1,978.00 | $2,790.00 |