| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $873.60 | $1,821.00 | $9,477.00 | |
Aetna
| Professional | $873.60 | $873.60 | $1,631.79 | |
United
| Facility | $375.00 | $1,056.00 | $2,558.00 | |
United
| Professional | $1,271.30 | $2,135.28 | $2,778.11 |