| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $912.01 | $2,454.71 | $6,606.93 | |
Aetna
| Professional | $1,698.24 | $1,698.24 | $4,466.84 | |
Medica
| Facility | $89.13 | $602.56 | $1,698.24 | |
United
| Facility | $138.04 | $616.60 | $1,659.59 |