| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $3,987.14 | $18,096.50 | $18,096.50 | |
Providence
| Facility | $2,687.87 | $5,189.60 | $5,427.48 | |
Providence
| Professional | $3,365.05 | $4,767.24 | $7,281.40 | |
United
| Professional | $4,842.85 | $5,976.31 | $9,585.76 |