| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $882.00 | $3,683.00 | $7,500.00 | |
Aetna
| Professional | $126.00 | $126.00 | $2,444.00 | |
Cigna
| Facility | $561.45 | $561.45 | $561.45 | |
Medica
| Facility | $139.00 | $634.00 | $1,676.40 | |
United
| Facility | $139.00 | $610.00 | $1,883.00 |