| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,949.00 | $3,949.00 | $6,907.00 | |
Aetna
| Professional | $53.15 | $99.73 | $115.39 | |
Cigna
| Professional | $64.48 | $100.58 | $206.02 | |
United
| Facility | $143.00 | $143.00 | $143.00 | |
United
| Professional | $92.90 | $132.56 | $251.19 |