| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $6,907.00 | $6,907.00 | $6,907.00 | |
Aetna
| Professional | $61.16 | $73.51 | $133.01 | |
Cigna
| Professional | $71.91 | $138.60 | $164.95 | |
United
| Professional | $110.24 | $142.66 | $352.53 |