| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $524.81 | $524.81 | $524.81 | |
Aetna
| Professional | $100.00 | $346.74 | $371.54 | |
United
| Facility | $75.86 | $75.86 | $75.86 | |
United
| Professional | $60.26 | $87.10 | $102.33 | |
Wellpoint
| Professional | $19.95 | $19.95 | $19.95 |