| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $6,907.00 | $6,907.00 | $6,907.00 | |
Aetna
| Professional | $28.85 | $59.99 | $95.88 | |
Cigna
| Professional | $33.75 | $77.93 | $112.80 | |
United
| Professional | $60.69 | $86.33 | $241.45 |