| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,736.00 | $4,736.00 | $6,907.00 | |
Aetna
| Professional | $316.38 | $375.76 | $375.76 | |
United
| Facility | $143.00 | $143.00 | $143.00 | |
United
| Professional | $485.02 | $675.50 | $1,311.36 |