| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,716.00 | $2,716.00 | $3,294.00 | |
Medica
| Facility | $500.00 | $500.00 | $1,300.00 | |
United
| Facility | $500.00 | $500.00 | $1,149.00 |
Subacuate/Other
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,716.00 | $2,716.00 | $3,294.00 | |
Medica
| Facility | $500.00 | $500.00 | $1,300.00 | |
United
| Facility | $500.00 | $500.00 | $1,149.00 |