| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $6,907.00 | $6,907.00 | $6,907.00 | |
Aetna
| Professional | $15.50 | $75.06 | $132.91 | |
Cigna
| Professional | $88.09 | $88.09 | $88.09 | |
United
| Professional | $76.55 | $105.38 | $245.26 |