| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,041.74 | $4,897.79 | $8,511.38 | |
Medica
| Facility | $977.24 | $1,513.56 | $5,495.41 | |
Medica
| Facility | AS | $181.97 | $467.74 | $467.74 |
United
| Facility | $2,884.03 | $3,548.13 | $11,748.98 |