| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $131.12 | $3,355.77 | $6,986.00 | |
Aetna
| Facility | 52 | $29.62 | $55.69 | $79.42 |
Cigna
| Facility | $3,438.00 | $3,438.00 | $3,438.00 | |
United
| Facility | $1,341.00 | $2,626.00 | $5,864.00 |