| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $143.02 | $16,607.43 | $26,034.23 | |
Aetna
| Professional | $55.65 | $55.65 | $70.11 | |
Cigna
| Facility | $54.57 | $54.57 | $54.57 | |
Cigna
| Professional | $55.65 | $55.65 | $55.65 | |
United
| Professional | $55.65 | $58.99 | $83.48 |