| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $277.81 | $432.88 | $671.49 | |
Providence
| Facility | $277.33 | $412.20 | $738.64 | |
Providence
| Professional | $821.84 | $966.92 | $966.92 | |
United
| Professional | $614.29 | $771.13 | $943.38 |