| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $5,011.87 | $5,011.87 | $5,011.87 | |
Aetna
| Professional | $5,011.87 | $5,011.87 | $5,011.87 | |
Select Health
| Professional | $120.23 | $120.23 | $120.23 | |
United
| Professional | $891.25 | $891.25 | $891.25 |