| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,338.00 | $4,338.00 | $6,849.00 | |
Aetna
| Professional | $13,753.37 | $13,753.37 | $13,753.37 | |
Medica
| Facility | $3,143.00 | $23,243.20 | $37,684.23 | |
United
| Facility | $3,143.00 | $3,143.00 | $3,143.00 |