| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,747.00 | $2,747.00 | $2,747.00 | |
Aetna
| Professional | $172.44 | $172.44 | $172.44 | |
United
| Facility | $2,446.00 | $2,446.00 | $2,446.00 | |
United
| Professional | $523.66 | $1,177.97 | $7,050.64 |