| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $787.00 | $2,747.00 | $8,229.00 | |
Aetna
| Professional | $2,843.00 | $2,843.00 | $8,229.00 | |
CareSource
| Professional | $80,849.19 | $80,849.19 | $80,849.19 | |
United
| Facility | $50.00 | $597.00 | $3,176.00 |