| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,137.96 | $4,786.30 | $10,471.29 | |
Aetna
| Professional | $1,513.56 | $1,819.70 | $3,630.78 | |
Medica
| Facility | $54.95 | $446.68 | $1,698.24 | |
United
| Facility | $181.97 | $416.87 | $1,778.28 |