| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $122.15 | $3,529.60 | $28,080.08 | |
Aetna
| Professional | $47.53 | $47.53 | $5,820.00 | |
Cigna
| Professional | $47.52 | $47.52 | $47.52 | |
United
| Professional | $47.53 | $71.30 | $112.80 |