| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,338.00 | $4,338.00 | $4,338.00 | |
Aetna
| Professional | $16,737.61 | $16,737.61 | $16,737.61 | |
Medica
| Facility | $7,865.00 | $28,286.56 | $45,861.05 | |
United
| Facility | $7,865.00 | $7,865.00 | $7,865.00 |