| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $872.91 | $872.91 | $872.91 | |
Aetna
| Professional | $508.56 | $630.01 | $630.01 | |
Cigna
| Facility | $493.38 | $493.38 | $493.38 | |
Cigna
| Professional | $397.11 | $872.26 | $1,097.50 | |
United
| Professional | $318.80 | $455.43 | $1,669.91 |