| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,900.00 | $1,900.00 | $3,200.00 | |
Medica
| Facility | $1,227.00 | $1,227.00 | $5,000.00 | |
Quartz
| Facility | $382.00 | $575.00 | $5,000.00 | |
United
| Facility | $1,227.00 | $1,227.00 | $1,300.00 |