| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,338.00 | $4,338.00 | $4,338.00 | |
Aetna
| Professional | $18,028.12 | $18,028.12 | $18,028.12 | |
Medica
| Facility | $6,571.00 | $30,467.52 | $49,397.05 | |
Midlands
| Facility | $19,670.59 | $19,670.59 | $22,949.03 | |
United
| Facility | $6,571.00 | $6,571.00 | $6,571.00 |