| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,778.28 | $4,466.84 | $4,466.84 | |
Aetna
| Professional | $478.63 | $588.84 | $616.60 | |
United
| Facility | $1,995.26 | $1,995.26 | $1,995.26 | |
United
| Professional | $416.87 | $758.58 | $933.25 |