| 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 | $3,085.00 | $4,262.00 | $17,636.00 | |
United
| Professional | $300.61 | $384.50 | $568.73 |