| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $8,128.31 | $8,128.31 | $8,128.31 | |
Aetna
| Professional | $251.19 | $354.81 | $1,096.48 | |
Cigna
| Professional | $245.47 | $416.87 | $645.65 | |
United
| Professional | $281.84 | $354.81 | $1,023.29 |