| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $6,907.00 | $6,907.00 | $6,907.00 | |
Aetna
| Professional | $1,536.53 | $1,536.53 | $1,651.15 | |
Cigna
| Professional | $1,326.54 | $1,744.05 | $2,027.31 | |
United
| Professional | $1,263.64 | $1,550.97 | $3,575.08 |