| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,758.00 | $4,456.00 | $5,299.00 | |
Aetna
| Professional | $228.02 | $228.02 | $228.02 | |
United
| Facility | $1,078.00 | $1,078.00 | $1,078.00 | |
United
| Professional | $198.89 | $283.88 | $401.00 |