| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $10,290.00 | $10,290.00 | $10,290.00 | |
Cigna
| Facility | $15,599.64 | $17,939.59 | $29,102.59 | |
Medica
| Facility | $5,850.44 | $6,091.68 | $14,126.94 | |
United
| Facility | $5,850.44 | $6,091.68 | $14,409.29 |