| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,201.78 | $1,201.78 | $8,500.00 | |
Aetna
| Professional | $1,201.78 | $1,201.78 | $1,201.78 | |
Medica
| Facility | $1,201.78 | $1,201.78 | $2,043.03 | |
United
| Facility | $1,978.00 | $1,978.00 | $1,978.00 |