| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $7,244.36 | $7,244.36 | $7,244.36 | |
Aetna
| Professional | $12.88 | $52.48 | $61.66 | |
United
| Facility | $1,995.26 | $1,995.26 | $1,995.26 | |
United
| Professional | $22.91 | $33.88 | $87.10 |