| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $907.20 | $907.20 | $1,252.80 | |
Aetna
| Professional | $432.00 | $907.20 | $907.20 | |
Cigna
| Facility | $468.00 | $542.88 | $1,291.68 | |
Cigna
| Professional | $827.24 | $827.24 | $1,034.05 | |
United
| Professional | $302.39 | $432.00 | $720.00 |