| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $388.08 | $510.82 | $1,101.45 | |
Aetna
| Professional | $457.56 | $490.51 | $775.18 | |
Ambetter
| Professional | $300.00 | $300.00 | $300.00 | |
Medica
| Facility | $457.56 | $526.19 | $1,526.17 | |
Medica
| Professional | $883.24 | $883.24 | $1,056.61 | |
United
| Professional | $883.24 | $883.24 | $936.23 |