| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $171.00 | $171.00 | $171.00 | |
Cigna
| Facility | $254.26 | $254.26 | $254.26 | |
Cigna
| Professional | $1,064.88 | $1,064.88 | $1,064.88 | |
United
| Professional | $125.38 | $356.01 | $364.61 |