| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,048.00 | $4,048.00 | $4,048.00 | |
Cigna
| Facility | $2,288.00 | $2,288.00 | $2,288.00 | |
Cigna
| Professional | $4,044.92 | $4,044.92 | $5,056.14 | |
United
| Professional | $1,232.00 | $1,689.60 | $3,520.00 |