| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,507.00 | $5,389.00 | $12,154.00 | |
Aetna
| Professional | $2,507.00 | $4,610.00 | $8,000.00 | |
Medica
| Facility | $180.00 | $757.00 | $1,300.00 | |
United
| Facility | $245.00 | $760.00 | $1,300.00 |