| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $988.00 | $2,898.00 | $3,444.00 | |
Aetna
| Professional | $4,459.20 | $4,459.20 | $7,500.00 | |
United
| Facility | $1,078.00 | $1,078.00 | $1,078.00 | |
University Health Alliance
| Professional | $29.27 | $29.27 | $29.27 |