| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $248.71 | $248.71 | $1,040.33 | |
Providence
| Facility | $248.71 | $248.71 | $1,144.35 | |
Providence
| Professional | $1,800,000.00 | $2,250,000.00 | $2,400,000.00 | |
United
| Professional | $197.62 | $197.62 | $197.62 |