| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $37,389.15 | $37,389.15 | $37,389.15 | |
Aetna
| Professional | $164.25 | $164.25 | $197.48 | |
Cigna
| Facility | $160.13 | $160.13 | $160.13 | |
Cigna
| Professional | $164.25 | $164.25 | $164.25 | |
United
| Professional | $156.04 | $174.11 | $210.24 |