| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,140.00 | $3,140.00 | $6,907.00 | |
Aetna
| Professional | $627.40 | $805.77 | $805.77 | |
United
| Facility | $143.00 | $143.00 | $143.00 | |
United
| Professional | $360.10 | $493.47 | $990.26 |