| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1,332.43 | $1,412.59 | $1,637.56 | |
Medica
| Facility | $1,358.93 | $1,412.59 | $1,696.30 | |
Medica
| Professional | $1,342.67 | $1,342.67 | $1,342.67 | |
United
| Professional | $1,342.67 | $1,342.67 | $1,342.67 |