| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $6,907.00 | $6,907.00 | $6,907.00 | |
Aetna
| Professional | $90.38 | $104.90 | $104.90 | |
Cigna
| Professional | $103.76 | $137.59 | $164.76 | |
United
| Professional | $104.30 | $143.43 | $259.17 |