| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,000.00 | $2,630.27 | $6,606.93 | |
Medica
| Facility | $691.83 | $1,258.93 | $6,918.31 | |
Medica
| Facility | 52 | $2,754.23 | $2,754.23 | $2,754.23 |
United
| Facility | $346.74 | $1,949.84 | $6,165.95 |