| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $159.59 | $2,833.00 | $5,743.00 | |
Aetna
| Facility | 50 | $917.96 | $917.96 | $917.96 |
Aetna
| Professional | 50 | $98.88 | $170.92 | $897.15 |
United
| Facility | $1,078.00 | $1,556.00 | $4,495.00 |