| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $5,915.63 | $5,915.63 | $5,915.63 | |
Aetna
| Professional | $2,016.42 | $2,016.42 | $2,016.42 | |
Cigna
| Professional | $2,016.42 | $2,016.42 | $2,016.42 | |
United
| Professional | $2,016.42 | $2,159.69 | $2,489.98 |