| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,131.00 | $6,870.00 | $13,095.00 | |
Cigna
| Facility | $914.00 | $914.00 | $914.00 | |
Medica
| Facility | $831.21 | $1,145.70 | $1,991.82 | |
United
| Facility | $783.00 | $1,743.00 | $5,562.00 |