| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,338.00 | $4,338.00 | $4,338.00 | |
Aetna
| Professional | $9,804.54 | $9,804.54 | $9,804.54 | |
Medica
| Facility | $2,714.00 | $16,569.68 | $16,569.68 | |
Midlands
| Facility | $5,937.53 | $7,954.64 | $11,519.08 | |
United
| Facility | $2,714.00 | $2,714.00 | $2,714.00 |