| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,706.14 | $5,496.04 | $9,975.91 | |
Aetna
| Facility | 50 | $6,456.84 | $6,456.84 | $6,456.84 |
Cigna
| Facility | $1,325.00 | $1,325.00 | $5,315.63 | |
United
| Facility | $3,713.00 | $6,315.00 | $12,945.00 |