| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,528.00 | $6,084.00 | $7,424.00 | |
Aetna
| Professional | $2,425.50 | $2,425.50 | $2,425.50 | |
United
| Facility | $2,912.00 | $2,912.00 | $2,912.00 | |
University Health Alliance
| Professional | $29.27 | $29.27 | $29.27 |