| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $260.17 | $405.73 | $628.83 | |
Providence
| Facility | $259.93 | $386.01 | $691.71 | |
Providence
| Professional | $770.28 | $906.26 | $906.26 | |
United
| Professional | $612.00 | $710.75 | $856.81 |