| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,024.22 | $1,024.22 | $8,500.00 | |
Aetna
| Facility | 52 | $512.11 | $512.11 | $512.11 |
Medica
| Facility | $870.59 | $1,288.70 | $2,214.15 | |
United
| Facility | $681.00 | $681.00 | $681.00 |