| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $957.00 | $3,569.00 | $18,600.00 | |
Cigna
| Facility | $624.00 | $17,112.00 | $17,112.00 | |
Medica
| Facility | $185.00 | $653.53 | $1,436.64 | |
United
| Facility | $191.00 | $550.00 | $1,769.00 |