| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,338.00 | $4,338.00 | $4,937.00 | |
Aetna
| Professional | $15,815.07 | $15,815.07 | $15,815.07 | |
Medica
| Facility | $6,571.00 | $26,727.47 | $43,333.29 | |
Midlands
| Facility | $19,001.45 | $19,001.45 | $22,168.35 | |
United
| Facility | $6,571.00 | $6,571.00 | $6,571.00 |