| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $5,011.87 | $22,908.68 | $39,810.72 | |
Aetna
| Professional | $676.08 | $676.08 | $10,232.93 | |
Medica
| Facility | $1,148.15 | $14,791.08 | $28,183.83 | |
United
| Facility | $6,606.93 | $6,606.93 | $6,606.93 |