| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $6,907.00 | $6,907.00 | $6,907.00 | |
Aetna
| Professional | $113.97 | $120.52 | $120.52 | |
Cigna
| Professional | $115.72 | $166.32 | $222.06 | |
United
| Professional | $116.47 | $150.72 | $290.27 |