| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,747.00 | $2,747.00 | $2,747.00 | |
Aetna
| Professional | $1,456.81 | $2,695.30 | $2,695.30 | |
HMSA
| Professional | $9,474.00 | $12,802.00 | $15,264.00 | |
United
| Facility | $1,078.00 | $1,078.00 | $1,078.00 |