| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,000.00 | $3,311.31 | $6,606.93 | |
Medica
| Facility | $489.78 | $3,311.31 | $7,244.36 | |
Medica
| Facility | 62 | $10,715.19 | $10,715.19 | $10,715.19 |
United
| Facility | $346.74 | $1,949.84 | $6,165.95 |