| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,486.00 | $3,883.00 | $4,705.00 | |
Aetna
| Professional | $653.25 | $1,524.00 | $5,259.20 | |
United
| Facility | $1,106.00 | $1,106.00 | $1,106.00 | |
University Health Alliance
| Professional | $29.27 | $2,594.00 | $3,580.00 |