| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1,139.00 | $1,139.00 | $1,139.00 | |
Medica
| Facility | $85.00 | $100.00 | $100.00 | |
Medica
| Professional | $4,560.00 | $4,800.00 | $5,292.96 | |
United
| Professional | $4,800.00 | $4,800.00 | $5,424.00 |