| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $4,969.00 | $4,969.00 | $4,969.00 | |
Medica
| Facility | $85.00 | $100.00 | $100.00 | |
Medica
| Professional | $844.48 | $888.93 | $980.22 | |
United
| Professional | $888.93 | $888.93 | $1,004.49 |