| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $800.00 | $3,158.00 | $10,439.00 | |
Aetna
| Facility | 50 | $393.00 | $455.50 | $1,687.71 |
Cigna
| Facility | $624.00 | $624.00 | $624.00 | |
Medica
| Facility | $55.00 | $286.74 | $1,437.00 | |
United
| Facility | $191.00 | $550.00 | $1,769.00 |