| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $4,846.14 | $4,846.14 | $4,846.14 | |
Providence
| Facility | $1,890.85 | $1,890.85 | $1,933.55 | |
Providence
| Professional | $812.17 | $812.17 | $1,117.28 | |
United
| Professional | $1,459.65 | $1,684.21 | $2,589.98 |