| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $794.71 | $4,387.00 | $40,727.00 | |
Aetna
| Facility | 53 | $158.94 | $158.94 | $158.94 |
Cigna
| Facility | $14,746.82 | $18,042.95 | $30,211.89 | |
United
| Facility | $3,028.00 | $9,753.00 | $33,939.00 |