| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,747.00 | $8,210.00 | $14,027.98 | |
Aetna
| Professional | $780.00 | $780.00 | $780.00 | |
United
| Facility | $3,340.00 | $3,340.00 | $3,340.00 | |
University Health Alliance
| Professional | $11,411.00 | $11,981.00 | $14,841.00 |