| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,570.40 | $6,025.60 | $6,025.60 | |
Aetna
| Professional | $1,174.90 | $1,318.26 | $1,445.44 | |
United
| Facility | $2,137.96 | $2,137.96 | $2,137.96 | |
United
| Professional | $1,258.93 | $1,862.09 | $2,290.87 |