| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $2,337.96 | $3,713.77 | $6,068.54 | |
Providence
| Facility | $714.86 | $2,922.10 | $5,710.29 | |
Providence
| Professional | $1,252.56 | $1,340.55 | $6,446.97 | |
United
| Professional | $4,229.20 | $4,262.89 | $7,486.42 |