| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,346.00 | $5,405.00 | $16,900.00 | |
Medica
| Facility | $231.97 | $400.00 | $3,930.50 | |
Medica
| Facility | AS | $113.08 | $113.08 | $113.08 |
United
| Facility | $139.00 | $634.00 | $2,526.73 |