| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $3,212.30 | $3,212.30 | $3,212.30 | |
Providence
| Facility | $1,280.50 | $1,280.50 | $1,337.74 | |
Providence
| Professional | $546.24 | $546.24 | $739.24 | |
United
| Professional | $955.25 | $1,138.95 | $1,708.48 |