| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $6,907.00 | $6,907.00 | $6,907.00 | |
Aetna
| Professional | $97.63 | $97.63 | $138.82 | |
Cigna
| Professional | $104.87 | $156.63 | $222.78 | |
United
| Professional | $127.21 | $182.94 | $237.16 |