| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $6,907.00 | $6,907.00 | $6,907.00 | |
Aetna
| Professional | $89.38 | $89.38 | $126.05 | |
Cigna
| Professional | $92.25 | $133.18 | $189.32 | |
United
| Professional | $112.60 | $151.29 | $332.84 |