| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $874.00 | $874.00 | $874.00 | |
Aetna
| Professional | $509.20 | $509.20 | $630.79 | |
United
| Professional | $319.20 | $456.00 | $1,672.00 |
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $874.00 | $874.00 | $874.00 | |
Aetna
| Professional | $509.20 | $509.20 | $630.79 | |
United
| Professional | $319.20 | $456.00 | $1,672.00 |