| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $114.17 | $1,632.00 | $4,478.00 | |
Aetna
| Professional | $114.17 | $114.17 | $213.32 | |
United
| Facility | $590.00 | $1,263.00 | $2,558.00 | |
United
| Professional | $170.55 | $216.85 | $360.95 |