| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $317.14 | $375.80 | $564.04 | |
Providence
| Facility | $177.60 | $470.51 | $805.22 | |
Providence
| Professional | $526.30 | $619.21 | $1,045.09 | |
United
| Professional | $701.24 | $865.36 | $999.65 |