| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $750.00 | $1,831.00 | $2,958.00 | |
Aetna
| Facility | 52 | $711.83 | $711.83 | $2,178.64 |
Cigna
| Facility | $588.00 | $1,000.00 | $1,000.00 | |
United
| Facility | $985.00 | $3,428.00 | $9,515.00 |