| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,365.16 | $4,365.16 | $4,897.79 | |
Aetna
| Professional | $11,220.18 | $11,220.18 | $11,220.18 | |
Medica
| Facility | $2,691.53 | $16,595.87 | $30,199.52 | |
United
| Facility | $2,691.53 | $2,691.53 | $2,691.53 |