| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,507.00 | $5,560.00 | $12,154.00 | |
Aetna
| Professional | $2,507.00 | $4,498.00 | $8,000.00 | |
Medica
| Facility | $2,209.00 | $5,048.00 | $30,268.98 | |
United
| Facility | $2,209.00 | $4,390.00 | $12,989.00 |