| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $71,167.10 | $71,167.10 | $71,167.10 | |
Aetna
| Professional | $71,167.10 | $71,167.10 | $71,167.10 | |
Cigna
| Facility | $71,167.10 | $71,167.10 | $71,167.10 | |
United
| Professional | $63,492.52 | $69,772.00 | $83,683.14 |