| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $6,907.00 | $6,907.00 | $6,907.00 | |
Aetna
| Professional | $1,389.94 | $1,389.94 | $1,500.84 | |
Cigna
| Professional | $1,192.23 | $1,584.68 | $1,945.26 | |
United
| Professional | $1,195.46 | $1,468.62 | $3,249.66 |