| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,201.78 | $1,201.78 | $1,201.78 | |
Aetna
| Professional | $1,201.78 | $1,201.78 | $1,201.78 | |
Medica
| Facility | $821.00 | $2,031.01 | $3,292.88 | |
United
| Facility | $821.00 | $821.00 | $821.00 |