| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,940.00 | $3,940.00 | $3,940.00 | |
Aetna
| Professional | $184.44 | $221.78 | $336.70 | |
Cigna
| Professional | $146.27 | $146.27 | $146.27 | |
United
| Professional | $98.57 | $151.65 | $402.31 |