| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $7,244.36 | $7,244.36 | $7,244.36 | |
Aetna
| Professional | $64.57 | $81.28 | $107.15 | |
United
| Facility | $144.54 | $144.54 | $501.19 | |
United
| Professional | $77.62 | $104.71 | $154.88 |