| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $870.96 | $870.96 | $870.96 | |
Aetna
| Professional | $602.56 | $630.96 | $758.58 | |
Cigna
| Facility | $489.78 | $489.78 | $489.78 | |
Cigna
| Professional | $870.96 | $870.96 | $1,096.48 | |
United
| Professional | $263.03 | $457.09 | $1,148.15 |