| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $239.88 | $239.88 | $239.88 | |
United
| Facility | $2,454.71 | $2,454.71 | $2,454.71 | |
United
| Professional | $323.59 | $331.13 | $416.87 | |
University Health Alliance
| Professional | $29.51 | $29.51 | $29.51 |