| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $686.02 | $1,641.00 | $9,477.00 | |
Aetna
| Professional | $686.02 | $686.02 | $5,206.81 | |
United
| Facility | $2,896.00 | $5,749.00 | $12,152.00 | |
United
| Professional | $956.52 | $1,195.65 | $2,294.37 |