| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $6,907.00 | $6,907.00 | $6,907.00 | |
Aetna
| Professional | $65.76 | $82.34 | $82.34 | |
United
| Facility | $143.00 | $143.00 | $143.00 | |
United
| Professional | $78.89 | $105.19 | $209.72 |