| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,747.00 | $8,210.00 | $10,007.00 | |
Aetna
| Professional | $1,146.59 | $1,146.59 | $1,146.59 | |
United
| Facility | $3,340.00 | $3,340.00 | $3,340.00 | |
University Health Alliance
| Professional | $7,885.79 | $11,671.00 | $19,500.00 |