| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $6,907.00 | $6,907.00 | $6,907.00 | |
Aetna
| Professional | $53.75 | $65.27 | $96.45 | |
Cigna
| Professional | $58.24 | $84.78 | $140.25 | |
United
| Professional | $82.06 | $167.69 | $224.93 |