| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,949.00 | $3,949.00 | $6,907.00 | |
Aetna
| Professional | $166.70 | $467.71 | $1,857.47 | |
Cigna
| Professional | $168.04 | $220.33 | $2,305.54 | |
United
| Facility | $100.00 | $100.00 | $100.00 | |
United
| Professional | $1,666.49 | $1,967.37 | $4,269.72 |