| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,758.00 | $4,456.00 | $5,299.00 | |
Aetna
| Professional | $672.00 | $672.00 | $672.00 | |
United
| Facility | $2,912.00 | $2,912.00 | $2,912.00 | |
University Health Alliance
| Professional | $29.27 | $29.27 | $29.27 |