| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $988.00 | $2,747.00 | $2,898.00 | |
Aetna
| Professional | $268.26 | $268.26 | $268.26 | |
United
| Facility | $2,155.00 | $2,155.00 | $2,155.00 | |
United
| Professional | $229.72 | $366.38 | $427.35 |