| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,747.00 | $14,614.14 | $59,252.00 | |
Aetna
| Professional | $11,652.00 | $11,652.00 | $20,400.00 | |
Cigna
| Facility | $842.00 | $842.00 | $842.00 | |
Providence
| Facility | $842.00 | $842.00 | $842.00 | |
United
| Facility | $2,364.00 | $7,664.00 | $36,803.00 |