| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,511.00 | $3,511.00 | $4,338.00 | |
Aetna
| Professional | $18,987.27 | $18,987.27 | $18,987.27 | |
Medica
| Facility | $6,571.00 | $32,088.49 | $52,025.12 | |
United
| Facility | $6,571.00 | $6,571.00 | $6,571.00 |