| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $12,589.25 | $12,589.25 | $12,589.25 | |
Aetna
| Professional | $36.31 | $4,570.88 | $5,128.61 | |
Cigna
| Professional | $27.54 | $27.54 | $27.54 | |
United
| Professional | $27.54 | $41.69 | $89.13 |