| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,500.00 | $10,439.00 | $17,642.00 | |
Aetna
| Facility | 52 | $585.46 | $585.46 | $639.66 |
Aetna
| Facility | 53 | $234.18 | $234.18 | $255.87 |
Cigna
| Facility | $22,968.00 | $27,391.00 | $34,239.00 | |
Medica
| Facility | $55.00 | $1,391.00 | $8,280.00 | |
United
| Facility | $1,967.00 | $4,960.00 | $11,732.00 |