| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,110.00 | $4,908.00 | $12,174.00 | |
Aetna
| Professional | $287.56 | $287.56 | $287.56 | |
Medica
| Facility | $287.56 | $808.04 | $2,675.00 | |
United
| Facility | $899.00 | $1,632.00 | $2,675.00 |