| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,500.00 | $7,655.00 | $13,151.00 | |
Aetna
| Professional | $3,600.00 | $3,600.00 | $7,655.00 | |
Medica
| Facility | $55.00 | $405.00 | $1,661.00 | |
United
| Facility | $191.00 | $526.00 | $1,769.00 |