| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,365.16 | $4,365.16 | $4,365.16 | |
Aetna
| Professional | $15,488.17 | $15,488.17 | $15,488.17 | |
Medica
| Facility | $6,606.93 | $22,908.68 | $42,657.95 | |
United
| Facility | $6,606.93 | $6,606.93 | $6,606.93 |