| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,507.00 | $5,389.00 | $9,823.00 | |
Aetna
| Professional | $2,507.00 | $4,125.00 | $8,000.00 | |
Medica
| Facility | $1,438.00 | $3,133.00 | $14,725.92 | |
United
| Facility | $1,438.00 | $2,874.00 | $5,813.00 |