| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,747.00 | $8,431.00 | $10,303.00 | |
Aetna
| Professional | $965.27 | $965.27 | $1,168.39 | |
United
| Facility | $2,155.00 | $2,155.00 | $2,155.00 | |
United
| Professional | $1,246.68 | $1,600.47 | $2,370.19 |