| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $616.60 | $616.60 | $616.60 | |
Aetna
| Professional | $426.58 | $446.68 | $537.03 | |
Cigna
| Facility | $354.81 | $354.81 | $354.81 | |
Cigna
| Professional | $616.60 | $616.60 | $776.25 | |
United
| Professional | $190.55 | $323.59 | $812.83 |