| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $8,500.00 | $8,500.00 | $10,000.00 | |
Medica
| Facility | $189.01 | $239.73 | $567.03 | |
Medica
| Professional | $216.17 | $369.02 | $472.80 | |
United
| Professional | $220.05 | $393.04 | $472.80 |