| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $346.17 | $346.17 | $346.17 | |
Aetna
| Professional | $346.17 | $346.17 | $350.24 | |
Medica
| Facility | $346.17 | $367.75 | $982.67 | |
Medica
| Professional | $359.48 | $1,011.56 | $3,763.97 |