| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,181.00 | $1,997.00 | $9,477.00 | |
Aetna
| Professional | $5,800.96 | $6,144.18 | $11,345.62 | |
Qualchoice
| Professional | $2,153.94 | $2,153.94 | $2,153.94 | |
United
| Facility | $2,896.00 | $5,749.00 | $12,152.00 | |
United
| Professional | $9,112.62 | $11,549.94 | $19,852.31 |