| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $891.25 | $891.25 | $891.25 | |
Aetna
| Professional | $602.56 | $616.60 | $645.65 | |
Cigna
| Professional | $891.25 | $891.25 | $1,096.48 | |
United
| Professional | $269.15 | $467.74 | $1,148.15 |