| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,429.00 | $5,247.00 | $12,600.00 | |
Aetna
| Professional | $2,400.00 | $3,600.00 | $7,655.00 | |
Medica
| Facility | $225.62 | $1,087.00 | $10,160.00 | |
United
| Facility | $191.00 | $550.00 | $1,769.00 |