| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $11,093.00 | $11,093.00 | $11,093.00 | |
Cigna
| Facility | $2,200.00 | $2,200.00 | $2,200.00 | |
Providence
| Facility | $2,200.00 | $2,200.00 | $2,200.00 | |
United
| Facility | $500.00 | $1,168.00 | $3,064.00 |