| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,995.26 | $3,162.28 | $8,511.38 | |
Aetna
| Professional | $251.19 | $446.68 | $1,258.93 | |
Medica
| Facility | $5,248.07 | $5,248.07 | $5,248.07 | |
United
| Facility | $1,819.70 | $2,041.74 | $2,041.74 |