| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,140.00 | $3,140.00 | $6,907.00 | |
Aetna
| Professional | $104.81 | $116.40 | $231.44 | |
Cigna
| Professional | $173.49 | $173.49 | $173.49 | |
United
| Professional | $239.57 | $323.48 | $688.41 |