| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $627.98 | $627.98 | $2,290.00 | |
Aetna
| Professional | $627.98 | $627.98 | $36,832.00 | |
Medica
| Facility | $898.01 | $2,624.13 | $62,246.08 | |
United
| Facility | $821.00 | $821.00 | $821.00 |