| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,736.00 | $4,736.00 | $6,907.00 | |
Aetna
| Professional | $149.06 | $149.06 | $159.56 | |
Cigna
| Professional | $122.32 | $177.02 | $201.79 | |
United
| Professional | $137.36 | $171.53 | $348.23 |