| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,861.20 | $2,861.20 | $2,861.20 | |
Aetna
| Professional | $2,065.04 | $2,065.04 | $2,065.04 | |
Cigna
| Professional | $2,859.20 | $2,859.20 | $3,574.00 | |
United
| Professional | $870.80 | $1,044.96 | $2,488.00 |