| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $297.06 | $297.06 | $297.06 | |
Medica
| Facility | $311.91 | $311.91 | $311.91 | |
Medica
| Professional | $351.97 | $351.97 | $498.44 | |
United
| Professional | $351.97 | $351.97 | $498.44 |