| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,629.00 | $3,600.00 | $12,154.00 | |
Aetna
| Professional | $1,361.00 | $2,624.00 | $7,655.00 | |
Medica
| Facility | $55.00 | $416.00 | $1,685.00 | |
United
| Facility | $191.00 | $550.00 | $1,769.00 |