| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $575.44 | $1,071.52 | $2,454.71 | |
Aetna
| Professional | $223.87 | $1,122.02 | $1,412.54 | |
United
| Facility | $371.54 | $1,071.52 | $2,570.40 | |
United
| Professional | $616.60 | $1,047.13 | $1,412.54 |