| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,506.00 | $7,655.00 | $18,600.00 | |
Cigna
| Facility | $624.00 | $624.00 | $624.00 | |
Medica
| Facility | $2,090.98 | $3,464.50 | $8,000.00 | |
United
| Facility | $2,729.00 | $8,000.00 | $17,483.00 |