| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $869.77 | $869.77 | $1,201.09 | |
Aetna
| Professional | $414.17 | $869.77 | $869.77 | |
Cigna
| Facility | $448.69 | $520.48 | $1,238.38 | |
United
| Professional | $289.92 | $414.17 | $690.29 |