| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,338.00 | $4,338.00 | $6,702.00 | |
Aetna
| Professional | $19,207.86 | $19,207.86 | $19,207.86 | |
Medica
| Facility | $1,571.69 | $27,467.24 | $32,461.28 | |
United
| Facility | $6,571.00 | $6,571.00 | $6,571.00 |