| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $280.86 | $412.43 | $429.48 | |
Providence
| Facility | $377.94 | $412.43 | $635.14 | |
Providence
| Professional | $1,800,000.00 | $2,250,000.00 | $2,400,000.00 | |
United
| Professional | $128.47 | $128.47 | $128.47 |