| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,629.00 | $3,569.00 | $10,439.00 | |
Aetna
| Professional | $1,361.00 | $2,624.00 | $7,655.00 | |
Medica
| Facility | $55.00 | $5,625.00 | $11,642.00 | |
United
| Facility | $2,269.00 | $6,170.00 | $12,989.00 |