| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $7,943.28 | $12,022.64 | $13,489.63 | |
Aetna
| Professional | $6,025.60 | $7,943.28 | $7,943.28 | |
Medica
| Facility | $6,025.60 | $7,943.28 | $10,715.19 | |
Medica
| Professional | $3,801.89 | $3,801.89 | $5,248.07 |