| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $8,500.00 | $8,500.00 | $8,500.00 | |
Medica
| Facility | $70.41 | $89.17 | $211.23 | |
Medica
| Professional | $80.70 | $137.75 | $175.93 | |
United
| Professional | $82.77 | $146.72 | $176.24 |