| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $240.00 | $240.00 | $240.00 | |
Aetna
| Professional | $240.00 | $240.00 | $240.00 | |
United
| Facility | $650.00 | $1,754.00 | $5,201.00 | |
United
| Professional | $190.05 | $272.31 | $411.32 |