| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,150.00 | $3,742.00 | $18,600.00 | |
Medica
| Facility | $85.93 | $122.35 | $1,145.00 | |
Medica
| Facility | AS | $15.19 | $38.45 | $38.45 |
United
| Facility | $139.00 | $610.00 | $1,883.00 |