| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,697.58 | $1,697.58 | $4,493.00 | |
Aetna
| Professional | $1,748.25 | $1,748.25 | $1,748.25 | |
Cigna
| Professional | $1,748.25 | $1,748.25 | $1,748.25 | |
United
| Professional | $1,645.41 | $1,713.97 | $2,570.96 |