| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $26.92 | $1,288.25 | $1,288.25 | |
Aetna
| Professional | $19.95 | $25.12 | $53.70 | |
Emblem Health
| Professional | $15.49 | $20.89 | $30.20 | |
United
| Professional | $48.98 | $57.54 | $83.18 |