| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,940.00 | $3,940.00 | $3,940.00 | |
Aetna
| Professional | $103.63 | $136.03 | $165.00 | |
Cigna
| Professional | $88.53 | $88.53 | $88.53 | |
United
| Professional | $83.83 | $147.97 | $255.06 |