| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $809.00 | $3,420.00 | $11,453.00 | |
Aetna
| Professional | $895.00 | $4,028.00 | $12,767.00 | |
United
| Facility | $385.00 | $2,064.00 | $8,759.00 | |
Wellpoint
| Professional | $1,014.54 | $1,014.54 | $1,369.63 |