| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,140.00 | $4,500.00 | $6,907.00 | |
Aetna
| Professional | $131.97 | $166.06 | $166.06 | |
United
| Facility | $143.00 | $143.00 | $143.00 | |
United
| Professional | $335.60 | $443.10 | $868.60 |