| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,548.13 | $4,073.80 | $4,365.16 | |
Aetna
| Professional | $588.84 | $588.84 | $1,174.90 | |
Medica
| Facility | $4,466.84 | $4,466.84 | $7,244.36 | |
United
| Facility | $4,466.84 | $4,466.84 | $4,466.84 |