| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1,985.43 | $1,985.43 | $1,985.43 | |
Providence
| Facility | $778.05 | $778.05 | $800.75 | |
Providence
| Professional | $333.20 | $333.20 | $458.38 | |
United
| Professional | $598.00 | $690.00 | $1,061.91 |