| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $803.00 | $2,825.00 | $7,542.00 | |
Aetna
| Professional | $975.00 | $3,944.00 | $12,040.00 | |
United
| Facility | $1,634.00 | $4,345.00 | $10,600.00 | |
Wellpoint
| Professional | $392.04 | $392.04 | $529.25 |