| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,472.25 | $3,472.25 | $3,472.25 | |
Aetna
| Professional | $3,033.65 | $3,033.65 | $3,472.25 | |
Providence
| Facility | $3,045.83 | $3,045.83 | $3,045.83 | |
United
| Professional | $3,045.83 | $3,045.83 | $3,045.83 |