| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $7,926.82 | $7,926.82 | $7,926.82 | |
Aetna
| Professional | $99.12 | $99.12 | $3,511.20 | |
Cigna
| Professional | $99.13 | $99.13 | $99.13 | |
United
| Professional | $105.08 | $148.69 | $306.87 |