| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $27,159.90 | $27,159.90 | $27,159.90 | |
Aetna
| Professional | $34.04 | $34.04 | $85.47 | |
Cigna
| Professional | $34.04 | $34.04 | $34.04 | |
United
| Professional | $34.04 | $51.08 | $82.94 |