| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,277.00 | $2,236.13 | $3,696.49 | |
Aetna
| Facility | 52 | $1,086.10 | $1,118.07 | $1,630.16 |
Cigna
| Facility | $515.00 | $541.00 | $561.00 | |
United
| Facility | $375.00 | $1,056.00 | $2,421.00 |