| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $6,907.00 | $6,907.00 | $6,907.00 | |
Aetna
| Professional | $1,639.22 | $1,639.22 | $1,760.80 | |
Cigna
| Professional | $1,407.24 | $1,827.13 | $2,148.52 | |
United
| Professional | $1,365.24 | $1,695.12 | $3,750.84 |