| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,152.00 | $3,947.00 | $13,401.00 | |
Aetna
| Professional | $1,342.00 | $6,000.00 | $14,449.00 | |
United
| Facility | $385.00 | $2,064.00 | $8,759.00 | |
Wellpoint
| Professional | $1,014.54 | $1,014.54 | $1,369.63 |