| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $307.00 | $307.00 | $307.00 | |
Cigna
| Facility | $1,114.07 | $1,114.07 | $1,237.85 | |
Medica
| Facility | $400.00 | $876.00 | $2,568.00 | |
United
| Facility | $400.00 | $903.00 | $2,568.00 |