| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $6,907.00 | $6,907.00 | $6,907.00 | |
Aetna
| Professional | $56.74 | $77.68 | $109.60 | |
Cigna
| Professional | $57.40 | $101.95 | $168.49 | |
United
| Professional | $93.41 | $128.44 | $252.55 |