| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,073.80 | $4,073.80 | $4,073.80 | |
Aetna
| Professional | $5,623.41 | $5,623.41 | $5,623.41 | |
Select Health
| Professional | $2,630.27 | $3,162.28 | $21,379.62 | |
United
| Professional | $4,168.69 | $4,168.69 | $5,128.61 |