| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $690.00 | $690.00 | $690.00 | |
Aetna
| Professional | $402.00 | $402.00 | $498.00 | |
Cigna
| Facility | $390.00 | $390.00 | $390.00 | |
Cigna
| Professional | $296.06 | $327.93 | $868.22 | |
United
| Professional | $252.00 | $360.00 | $1,320.00 |