| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,374.00 | $5,909.00 | $10,726.00 | |
Aetna
| Facility | 22 | $4,859.00 | $4,859.00 | $4,859.00 |
BCBS
| Facility | $4,452.00 | $7,264.00 | $12,274.00 | |
Cigna
| Facility | $2,659.03 | $2,820.06 | $3,619.61 | |
United
| Facility | $3,206.00 | $6,578.00 | $12,241.00 |