| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,570.40 | $4,897.79 | $8,511.38 | |
Aetna
| Professional | $3,715.35 | $5,128.61 | $11,220.18 | |
Medica
| Facility | $1,288.25 | $3,162.28 | $13,182.57 | |
United
| Facility | $1,819.70 | $2,818.38 | $5,248.07 |