| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,000.00 | $6,791.00 | $14,100.00 | |
Aetna
| Facility | 50 | $18,109.13 | $18,109.13 | $18,109.13 |
Cigna
| Facility | $624.00 | $624.00 | $624.00 | |
Medica
| Facility | $723.70 | $1,056.08 | $9,742.00 | |
United
| Facility | $2,729.00 | $8,000.00 | $17,483.00 |