| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,818.38 | $2,818.38 | $2,818.38 | |
Aetna
| Professional | $1,445.44 | $1,445.44 | $1,445.44 | |
United
| Facility | $2,454.71 | $2,454.71 | $2,454.71 | |
University Health Alliance
| Professional | $29.51 | $29.51 | $29.51 |