| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $104.15 | $4,667.00 | $9,950.00 | |
Aetna
| Facility | 50 | $2,664.01 | $3,374.41 | $8,811.00 |
Cigna
| Facility | $79.18 | $79.18 | $83.02 | |
United
| Facility | $1,516.00 | $3,352.00 | $10,536.00 |