| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,486.00 | $3,883.00 | $4,705.00 | |
Aetna
| Professional | $156.22 | $156.22 | $156.22 | |
United
| Facility | $1,078.00 | $1,078.00 | $1,078.00 | |
United
| Professional | $210.38 | $238.28 | $244.27 |