| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,747.00 | $2,747.00 | $2,747.00 | |
Aetna
| Professional | $1,119.60 | $1,119.60 | $1,119.60 | |
United
| Facility | $2,446.00 | $2,446.00 | $2,446.00 | |
United
| Professional | $1,213.98 | $1,959.89 | $2,474.09 |