| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,736.00 | $4,736.00 | $6,907.00 | |
Aetna
| Professional | $170.83 | $228.02 | $263.04 | |
Cigna
| Facility | $640.00 | $640.00 | $640.00 | |
United
| Professional | $200.73 | $238.36 | $552.00 |