| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,365.16 | $4,365.16 | $4,365.16 | |
Aetna
| Professional | $22,908.68 | $22,908.68 | $22,908.68 | |
Medica
| Facility | $5,370.32 | $34,673.69 | $63,095.73 | |
United
| Facility | $5,370.32 | $5,370.32 | $5,370.32 |