| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,000.00 | $3,684.00 | $18,600.00 | |
Aetna
| Professional | $655.61 | $655.61 | $1,383.34 | |
Medica
| Facility | $590.04 | $1,160.00 | $3,790.62 | |
United
| Facility | $498.00 | $1,928.00 | $3,790.62 |