| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $16,152.00 | $54,138.00 | $74,893.60 | |
Cigna
| Facility | $20,376.81 | $28,154.55 | $52,222.65 | |
Providence
| Facility | $20,376.81 | $28,154.55 | $52,222.65 | |
United
| Facility | $5,419.00 | $36,035.11 | $55,873.00 |