| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $6,907.00 | $6,907.00 | $6,907.00 | |
Aetna
| Professional | $43.00 | $47.04 | $78.58 | |
Cigna
| Professional | $46.87 | $75.63 | $109.80 | |
United
| Professional | $71.90 | $92.73 | $179.07 |