| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $6,025.60 | $6,025.60 | $7,244.36 | |
Aetna
| Facility | 50 | $2,290.87 | $2,290.87 | $2,290.87 |
Cigna
| Facility | $794.33 | $794.33 | $794.33 | |
United
| Facility | $501.19 | $501.19 | $501.19 |